What Is Pain and What Is Acute Pain - Coursework Example

Pain Management: Basbaum and Catherine (22) s that pain refers to unpleasant feeling that is always caused by a damaged stimulus, and an example includes the burning of a finger, hitting a toe on a stone, or even falling down. Smith (42) further maintains that pain refers to unpleasant emotional or sensory experience that is associated with potential or actual tissue damage. Smith (44) further states that pain normally motivates a person to withdraw from the damaging situation, for purposes of protecting the damaged body part while it is in the process of healing. Furthermore, pain helps to make an individual who has experienced it to avoid the action that made that pain possible in the future. Vallejo (57) explains that majority of pain normally end after the painful stimulus has been removed, and the body of the same individual has healed. On the hand, it is important to denote that on some occasions, pain will persist, despite an end to the stimulus, as well as the healing of an individual’s body. Furthermore, Basbaum and Catherine (27) maintain that it is possible for pain to arise when there is an absence of a disease, injury, or a detectable stimulus. This, in the view of Smith (39) is an example of chronic pain. Furthermore, pain is a very important symptom that always arises in any medical condition, and has the capability of interfering with the quality of life of an individual, and his or her general body functioning. Basbaum and Catherine (30) give an example of pain, and the most notable one is acute pain. Acute pain normally begins sharply and suddenly. It is always a warning to the emergence of a disease, or a threat to the body. This type of pain can be mild, and only last a few moments, or it can be severe, lasting for several weeks. However, once the problem to the body is solved, this acute pain will disappear. This paper discusses the pathophysiology of pain, the various theories of pain management, and the use of PCA in pain management, and its effects if it is poorly managed. This paper will discuss these aspects of pain management in view of Sarah Abraham, a patient suffering from adenocarcinoma. Pathophysiology of Pain: The nervous system of an individual consists of two major parts, namely the spinal cord and the brain. These two combine to create the central nervous system, and the motor as well as the sensory nerves that create the peripheral nervous system. To explain this situation, Ogawa (180) maintains that it is the role of the sensory nerves to send impulses on what is happening to the body, to the brain, and this is through the spinal cord. Furthermore, Basbaum and Catherine (33) maintain that the brain sends this message to the motor nerves, as a result, making the body to experience the action or the message. Ogawa (181) maintains that the pathophysiology of pain always begins with the nerves. For instance, in the case of Sarah Abrahams, she would begin experiencing pain on the various nerves surrounding the lung. An example of such kind of a nerve is the phrenic nerve. It is important to understand that adenocarcinoma is an example of a lung cancer, and this is the reason as to why Sarah Abrahams will start experiencing pain from the nerves of the lung. The phrenic nerve aids in breathing, and it passes between the lungs and the heart. Basbaum and Catherine (35) denotes that a variety of body sensory fibers normally respond to different situations, as a result, they produce different chemical responses that determine how the situation under consideration is interpreted. Some sensory nerves are able to send signals that are associated with a light touch, while other sensory nerves are able to send a signal that is associated with a deep pressure. Basbaum and Catherine (41) denote that a patient suffering from adenocarcinoma will always experience very deep and extensive pain. On this basis, the sensory nerves around the lungs will most definitely send a signal that has a deep pressure. Ogawa (183) states that there are special pain receptors that are called nociceptors, and they are always activated when the body of an individual experiences an injury, or an ailment. For example, the tissues found in Sarah Abrahams lungs will be compressed, and this would force the nociceptors found in the lungs of Sarah Abrahams to make a response. The response, or impulse created will pass through the nerves of the lungs, moving to the spinal cord all the way to the brain of an individual. Ogawa (182) maintains that this process normally occurs within a fraction of seconds. On the hand, the spinal cord contains the dorsal horn, which acts as the information hub of the body. It is important to state that the spinal cord normally makes some decisions, and these decisions are always called reflexes. For instance, when Sarah Abrahams begins experiencing some pains in her lungs, she may start making some body movements like touching her lungs. Basbaum and Catherine (31) explain that this immediate body movement by Sarah Abrahams can be referred to as a reflex action, and it has been made possible by the spinal cord. Furthermore, Nakae and Takashi (207) explain that it is the dorsal horn, in an individual’s body that sends a message to the brain, when an individual experiences an injury, or body damage, hence the emergence of pain. Ogawa (185) maintains that despite these reflex actions by the body, when an injury occurs, the pain signal will still be received by the brain. This is mainly because pain does not only involve a simple stimulus or response process. On this basis, Basbaum and Catherine (33) maintains that the pain that emanates from this disease suffered by Sarah Abrahams becomes catalogued in her brain, releasing the signal to the thalamus, which in turn plays a role in directing the pain to the various body parts for interpretation. Ogawa (184) denotes that the cortex is responsible for determining the area in which the pain came from, thus comparing it to other types of pain which are familiar with the body. Furthermore, Nakae and Takashi (206) maintain that pain signals are also sent to the limbic from the thalamus of the brain. The limbic system is the emotional center of an individual’s brain, and it is responsible for creating emotions such as a sense of crying. When the injury or the stimulus produced by the body stops, the pain sensation will most definitely stop. Abram (350) explains that this is mainly because the nociceptors will be unable to detect the tissue damage, or the injury of the body. This is always the case of an acute pain, and this is because it does not persist after the healing of the body, or an injury. There are a variety of theories developed for purposes of explaining the management of pain. One historical theory of pain is referred to as the specificity theory (Smith, 33). According to this theory, pain is a specific sensation that has its own sensory apparatus which are independent of touch. According to this theory, pain that emanates from the lungs of Sarah Abrahams has their own sensory apparatus, which is completely independent from that of the sense of touch. Furthermore, this theory denotes that this body system has its own receptors which are responsible for detecting stimuli, and its own pathway to the brain, as well as the peripheral nerve. Another theory is the intensive theory of pain, which came into prominence during the periods of the 18th and the 19th century. According to this theory, pain is an emotional state that emanates from extra strong stimuli, such as intense pressure, light, or even temperature. For instance, Sarah Abrahams will feel great pressure in her lungs due to the presence of the lung cancer; as a result she would experience pain. Based on this theory, it is this pressure experienced by at the lungs of Sarah Abrahams that causes pain. Nakae and Takashi (205) maintain that this theory gained considerable backing from most health care experts during the mid 1890s, to the 19th century. However, through experiments by Max von Frey and Henry Head, most medical experts migrated to specialty theory. And this is mainly because there wasn’t enough to prove the assertions contained in the intensive theory. The peripheral pattern theory came into existence in the year 1955, and it was developed by G. Weddell, as well as DC Sinclair. According to this theory, the skin fiber endings are identical, and pain is therefore produced through an intense stimulation of these skin fiber endings (Waldman, 44). The gate control theory was developed by Patrick Wall and Ronald Melzack in the year 1965 (Ogawa, 183). This theory denotes that the thin and large diameters of the nerve fibers are responsible for carrying information from the place of the injury, to the dorsal horn. Furthermore, this theory denotes that if there is a large fibre activity within the inhibitory cell, as opposed to a thin fibre activity at the same cell, then an individual would feel low pain. However, Abram (351) maintains that these theories have been superseded by the modern theories of pain management. In 1968, Kenneth Casey, and Ronald Melzack came up with the three dimensional theory of pain management. Nakae and Takashi (202) identify these three dimensions as, sensory-discriminative, affective-motivational, and cognitive-evaluative. The sensory-discriminative dimension entails the intensity of pain, while the affective-motivational dimension entails the unpleasantness that the pain causes. Nakae and Takashi (204) denote that these dimensions are not caused by the degree of a painful stimulus, but through higher cognitive activities responsible for influencing the perceived unpleasantness, as well as the intensity of pain. On the other hand, Abram (350) explains that the cognitive activities of an individual may have an impact on the affective, as well as the sensory experience of an individual, or they may even modify the affective-motivational dimension of pain. It is important to explain that patients can also have a control on the manner in which they manage their pain. This is referred to as PCA. PCA is an acronym of Patient controlled analgesia. This refers to any method that allows a person who is in pain to undertake any method that would relief them from the pain. One of the most common PCA is the self-administration of the oral prescription painkillers, or over the counter pain killers. An example of an over the counter painkillers that Sarah Abrahams can gain an access to includes paracetamols, or even morphine sulphate. However, it is important to denote that pain that emanates from adenocarcinoma cannot be easily contained by the use of these simple drugs. This is because of the kind of pressure that the lung cancer puts on the nerves surrounding the lungs. Nakae and Takashi (202) explains that because pain involves a combination of emotional state and tissue damage, then being in control involves managing to reduce the emotional aspects of pain. Nakae and Takashi (201) further argue that it is possible to use PCA in controlling acute as well as chronic pain. Furthermore, Basbaum and Catherine (37) maintain that infusion pumps in hospitals are always used to maintain pain that emanate from cancer ailments, as well as from post operation procedures. Furthermore, it is possible to administer PCA through an inhaler. The most common material used through this system is the analgizer. This instrument mainly uses methoxyflurane in the administration and control of pain. On most occasions, Nakae and Takashi (200) explain that analgizer is used on obstetric patients. This is particularly during periods of child birth. Furthermore, the PCA nasal spray is also developed, and they are advantageous because a patient is able to control on the number of times that he or she administers the program. This is more because its administration has a fixed period of time. However, if PCA is poorly managed, there are chances that the patient might get an over-dose, or even an under-dose of the medication. Furthermore, chances are high that a patient might abuse the narcotics which are used in the administration of pain. Conclusion: In conclusion, pain is a feeling that an individual feels after they have a damaged stimulus. Furthermore, there are two major body organs that play a role in ensuring that an individual feels the pain. This is the brain, as well as the spinal cord. From this paper, we can denote that there are two types of pain, acute, as well as chronic pain. Acute pain normally takes a shorter period of time, and it always ends with the healing of the wound, or the repair of the body tissue. On the other hand, chronic pain will always take a long period of time, for it to end. Various theories of pain management have been developed, and this includes the gate theory of pain management, peripheral pattern theory, intensity theory, three dimensional theories, as well as the specificity theory. Finally, a patient has the capability to control and manage the pain that they normally encounter. This situation is referred to as patient controlled analgesia. Works Cited: Abram, S.e.. "Is Ultrasound Guidance Advantageous for Interventional Pain Management? A Review of Acute Pain Outcomes." Yearbook of Anesthesiology and Pain Management 2012 (2012): 350-351. Print. Basbaum, A. I., and M. Catherine Bushnell. Science of pain. Oxford: Elsevier/Academic Press, 2009. Print. Nakae, Aya, and Takashi Mashimo. "Pain and emotion." Pain Research 25.4 (2010): 199-209. Print. Ogawa, Setsuro. "Management of neuropathic pain in the pain clinic practice." Pain Research 24.4 (2009): 179-189. Print. Smith, Howard S.. Pain management. Philadelphia, PA: Saunders, 2008. Print. Vallejo, R. "Interventional pain management." Techniques in Regional Anesthesia and Pain Management 9.2 (2005): 57-57. Print. Waldman, Steven D.. Pain management. 2nd ed. Philadelphia, PA: Elsevier/Saunders, 2011. Print. Read More