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Pain Management in Cardiac Surgery - Essay Example

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Pain Management in Cardiac Surgery Over the last years of medical advancement, significant improvements in assessment and management of surgical pain had been made. There has been an escalation in effectiveness of pain management as well as quality supporting literatures available…
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Pain Management in Cardiac Surgery
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Download file to see previous pages Overview of Pain and its Management Pain is a subjective and relatively complex perception that indicates presence or occurrence of tissue damage in the human body. It is the body’s natural response to infection or injury to signal the person that something is damaged in the system (Definition and Types of Pain, 2012). Nociception is the process involved in pain perception where stimuli from potential tissue damage are transmitted through peripheral and central nervous systems (Portenoy and Brennan, 1994). Stimulus begins in the detection of either mechanical, thermal or chemical changes in the pain receptors, also known as nociceptors, which is activated when the source is above the threshold of the person. The stimulus will then be transmitted along the spinal cord to the brain and in turn will trigger autonomic reaction of a subjective painful sensation (Clement, et al., 2000). Pain is necessary in recognition and diagnosis of health problems that may be acute or chronic. Acute and chronic pain differs in the onset and duration of painful sensation. Acute pain such as after surgery, trauma, and labour usually lasts for hours, days or weeks up to less than six months time. After the underlying cause is treated, the pain subsides along with the healing process of the illness. On the other hand, chronic pain are those experienced by the patients for months or even years where pain management has been less effective overtime (Definition and Types of Pain, 2012). There are three types of pain according to mechanism: nociceptive, neuropathic, and psychogenic. The first type, noriceptive pain, is primarily generated by pain receptors as previously discussed. Neuropathic pain involves potential damage in neurons or any part of the nervous system such as in cases of diabetic neuropathy and post-stroke pain. While psychogenic pain is associated with psychological disturbance occurring in anxious or depressed patients particularly those with chronic or terminal illnesses (Definition and Types of Pain, 2012). In this study, the acute type and noriceptive type of pain will be tackled as surgical pain falls into these categories. Neuropathic pain is further categorized into somatic and visceral where somatic pain is usually caused by integumentary, skeletal, and muscular injuries. Pain can be described as dull or aching in a localized area of the body. In cases that injury occurs in the skin or on tissues beneath, a sharper sensation of pain is usually experienced since nerve endings and pain receptors are rich in the integumentary system. The latter type, visceral pain, is initiated by injury of internal organs and are experienced as dull, stabbing or cramping sensation that is poorly localized (Janig, 1987). Surgical wounds can develop either or both depending on the part affected and the procedure done. Pain following a surgical procedure is expected especially in the invasive procedures where tissues and organs are damaged and repaired. Since it is primarily subjective, proper assessment must be well utilized. For adult patient or those above eighteen years old, interview and physical assessment are the critical part of assessment. Since they are able to verbalize their feelings, specifications of pain can be fully described. The essential components of the interview are asking the patient of the following: (1) characteristic – ...Download file to see next pagesRead More
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