| Autor: |
BOTEA, Mihai O., BIMBO-SZUHAI, Erika, MOISA, Ramona C., POPA, Georgiana M., BARSAC, Claudiu, PETRICA, Alina, MARZA, Adina, BOTEA, Raluca M. |
| Předmět: |
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| Zdroj: |
Human Education Today for Tomorrow's World; Nov2023, Issue 20, p73-89, 17p |
| Abstrakt: |
Pain-related complaints represent as many as 70% of presenting concerns for patients in the A&E departments or GP setting [2,15]. A wide variety of options are available for the treatment of pain, from which the most known and used are the analgesics. It is the responsibility of the professional care team to develop an effective person centred Pain Management strategy which appropriately assesses patients, analyses the results of the assessment and establish a pain management plan, while allowing the person to remain as independent and functional as possible. The approach to patients in pain should use a division of pain patients into four specific treatment groups: acute pain, chronic pain, recurrent pain and chronic pain of malignancy. In this chapter we will address mostly to the acute pain management. Pain treatment should be initiated promptly, titrated to an acceptable level of relief, and continued during the cause's investigation. It is inappropriate to delay analgesics use until a diagnosis has been made. There is no evidence that the administration of adequate doses of opioid analgesia to establish patient comfort impairs the medical ability to rich a diagnose of and emergency condition. To the contrary, administration of analgesia may enhance the accuracy of physical examination and patient assessmen [16, 17]. The medication useful in treating acute pain are similar to those used in treating other types of pain [1]. The World Health Organization (WHO) analgesic ladder (picture 1) developed for treating patients with cancer pain also provides a useful approach to treat acute pain. At the lowest level (mild pain) are recommended nonopioid analgesics such as paracetamol or/plus nonsteroidal anti-inflammatory drugs (NSADs) (e.g. ibuprofen). Such drugs have an analgesic ceiling; above a certain dose, no further analgesia effect is expected [1]. For moderate pain, are recommended combining paracetamol and/or a NSAID with an opioid (a weak opioid). The inclusion of paracetamol limits the amount of opioids that should be used within 24 hour period, with many benefits which will be discussed later in the chapter. For severe level of pain, a strong opioid such as morphine is a better choice; such opioids have no analgesic ceiling. Most postoperative or trauma patients initially respond better to a morphineequivalent opioid. By the moment the patient is eating, drinking and ready for discharge, a combination of oral analgesics including opioids and paracetamol plus/minus NSAID are most of the time an adequate option. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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