What is Pain
Pain is the disease’s most typical symptom. It is an unpleasant sensation that is located in a body district. It describes terms of a penetrating or tissue-destructive method (e.g., stabbing, burning, twisting, tearing, squeezing) or a physical or emotional reaction (e.g., scary, disgusting, sicking). Some pain of medium or higher severity is associated with anxiety and hence the urgency
Self-report is the key to pain assessment. In or pre-verbal children, facial expression is the most valid indicator of pain; therefore, use a faces pain scale to assess severity. Pain should be evaluated by:
- Severity, example: does the patient wake up because of the pain Site
- Character, e.g., stabbing, throbbing, crushing, cramp-like
- Persistent or intermittent
- Relieving or aggravating factors
- Accompanying symptoms
- Distribution of pain
- In children, pain can assess by Childs’ crying voice, posture, movement, and color.
Treatment for Acute and Mild pain
Aspirin, Paracetamol, and Non -steroidal Anti-Inflammatory Agents (NSAIDs); these drugs are considered together because they are used for similar problems and may have the same mechanism of action.
A: Acetylsalicylic acid 600mg every 4 hours until the pain subsides
A: Paracetamol 500- 100mg every 6-8 hours until the pain subsides.
A: Paracetamol 15 mg/kg/dose 4–6 hourly when required to a maximum of 4 doses per 24 hours;
Treatment for the Severe Pain
Opioids are currently available as the most effective pain-relieving medications. They have the broadest range of effectiveness, providing the most reliable and efficient method for fast pain relief.
Adults : C: Tramadol tablets or injection 50-100mg every 6 hours or until the pain is controlled.
C: Morphine 10mg IV every 6 hours on a “when necessary” basis; Children: 0.2mg/kg body weight IV every 6 hours.
For surgery and obstetric conditions
C: Pethidine 100mg IM/ IV every 6 hours when necessary.
CAUTION‼ Opioids may cause respiratory depression; therefore, they use opioids carefully. In case of toxicity, reverse with the narcotic antagonist naloxone.
C: Naloxone 0.1-0.2mg IV intermittently. Max. Dose 10mg
Do not administer morphine in:
- advanced liver disease
- severe head injury
- acute asthma
- advanced chronic obstructive bronchitis, emphysema or other
- respiratory disease with imminent respiratory failure
- untreated hypothyroidism
Use morphine with extreme care if there is:
- Recent or concurrent alcohol intake or other CNS depressants
- Hypovolaemia or shock
- In the elderly
Refer to Regional and Tertiary care for:
- All children with moderate and acute severe pain
- No response to oral pain control and unable to initiate opioids therapy
- Uncertain diagnosis
- Management of serious underlying conditions
Pain Associated with Trauma or Inflammation
See under Trauma and Injuries section
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