Natural analgesic systems
Nan Stalker in Pain Control, 2018
This chapter looks at the natural analgesic systems of the human body. It begins by discussing the endogenous opioid systems of the body and their role in controlling pain and considers how acupuncture draws upon these systems to control pain. The chapter discusses the issues of referred pain and projected or phantom pain. It explains the role of the endogenous opioid system in the control of pain and examines the role of acupuncture in pain control. The periaqueductal grey matter of the midbrain contains a high concentration of opioid receptors which, when stimulated electrically, produce profound analgesia. Morphine and morphine-like analgesic drugs exert their effect by stimulating the same receptors as do these natural opioid peptides. Acupuncture involves placing fine needles in certain defined areas of the skin in an attempt to attain analgesia in specific parts of the body.
Oxymorphone
Louis A. Pagliaro, Ann Marie Pagliaro in PNDR: Psychologists’ Neuropsychotropic Drug Reference, 2020
Oxymorphone rectal suppositories also may be of benefit for elderly, frail, or debilitated patients who may require a potent, rapid-acting analgesic and generally are unable to tolerate oral or injectable opiate analgesic pharmacotherapy. The oxymorphone injectable formulation contains sodium dithionite, a sulfite. Oxymorphone is a potent opiate analgesic that appears to elicit its analgesic action primarily by binding to the endorphin receptors in the CNS. Oxymorphone pharmacotherapy has been associated with abnormal contraction of the pupils or “pin-point pupils”, drowsiness, dysphoria, GI complaints, headache, itching, lightheadedness, nausea, respiratory depression, and vomiting. The signs and symptoms of oxymorphone overdosage resemble those associated with other opiate analgesic overdosage. Oxymorphone overdosage requires emergency symptomatic medical support of body systems with attention to increasing oxymorphone elimination. The opiate analgesic antagonist, naloxone, usually is required to reverse the respiratory depression associated with oxymorphone and other opiate analgesic overdosage.
The practice of pain management
Nan Stalker in Pain Control, 2018
This chapter looks at the management of pain and begins by considering the World Health Organisation analgesic ladder of pain management. The management of pain is one of the most important and difficult issues in nursing practice. The purpose of drugs in pain control is to keep the patient completely free of pain and this is probably best achieved by applying the World Health Organisation analgesic ladder of pain management. The patient’s experience of chronic pain can vary widely, and in general the weakest possible drugs necessary to control the pain are used. In chronic pain the patient will be receiving analgesic drugs continuously. This can give rise to a number of complications in the management of the patient and his or her pain. In many instances the principles adopted for the treatment of chronic pain also apply to terminal pain.
An international study of analgesic dependence among people with pain in the general population
Published in Substance Use & Misuse, 2019
Omimah Said, James Elander, Frances A. Maratos
Background: Overuse of and dependence on analgesics (including opioids and other pain medications) are major international public health problems. Objective: To identify influences on analgesic dependence among analgesic users in the general populations of different countries. Methods: Online surveys of 1,283 people with pain in the UK, USA, Australia, Germany, Egypt and China/Macau/Hong Kong. Results: Levels of analgesic overuse and dependence were highest in Egypt and lowest in China/Macau/Hong Kong. In every country except Egypt, frequency of pain and frequency of analgesic use were correlated with analgesic dependence, and scores on the Need subscale of the Pain Medication Attitudes Questionnaire (PMAQ) independently predicted analgesic dependence. In the UK, USA, Australia, and Germany, frequency of analgesic use mediated the effects of pain frequency or intensity, and Need scores mediated the effects of frequency of analgesic use. In Egypt, more recent pain, analgesic overuse, and the Emotion and Solicitude subscales of the Survey of Pain Attitudes independently predicted analgesic dependence. Conclusions: Across multiple countries, the impact of pain on analgesic dependence was mediated by frequency of analgesic use rather than overuse or abuse, and self-reported need for analgesics was the strongest independent predictor of dependence. Asking people directly about their feelings of needing analgesics could therefore identify those who could be helped to use analgesics less frequently, which should reduce their risk of dependence.
Temporal and Geographic Patterns in Opioid Abuse in Texas
Published in Journal of Addictive Diseases, 2012
Opioid analgesic abuse is an increasing problem in the United States. All opioid analgesic abuse exposures reported to Texas poison centers during 2000–2010 were identified and annual and geographic patterns were examined. The annual number of opioid analgesic abuse cases increased 160% from 441 in 2000 to 1,145 in 2010. The proportion of total opioid analgesic exposures reported to be due to abuse increased 55% from 11.4% in 2000 to 17.8% in 2010. The opioid analgesic rate per 100,000 was highest (90.15) in northeastern Texas and lowest (27.91) in the southern part of the state.
The effect of transcutaneous electrical nerve stimulation on post-thoracotomy pain
Published in Contemporary Nurse, 2015
Sevilay Erden, Sevilay Senol Celik
Background: Pain guidelines suggest transcutaneous electrical nerve stimulation (TENS) as a reliable analgesic method in postoperative pain. Objectives: This study was conducted as a randomized controlled study to determine the effect of TENS on postoperative pain and analgesic consumption in patients who have undergone posterolateral thoracotomy (PLT). Design: The study was conducted in the Thoracic Surgery Clinic of a university hospital with 40 patients (test group: 20, control group: 20) and its power was 99%. While, test group patients were administered TENS, the control group patients were not. The pain assessment and analgesic consumption in both groups were recorded. Results: The pain levels and analgesic consumption of the test group were lower than that of the control group (p < .05). Conclusions: TENS reduced PLT pain and analgesic consumption. Thus, TENS can be recommended as an easy and reliable analgesic method in PLT.
Related Knowledge Centers
- Pain
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