Question

A patient comes to the emergency department complaining of severe pain and requests something "strong" to help alleviate it. The doctor orders an opioid medication. The nurse believe the patient has a low tolerance. List factors that affect a patient's perception of pain and the pain response. Explain in detail how opioids (narcotics) block the pain impulses to the brain. Other than giving the patient medications, what other ways could be used to to help the patient reduce his pain?

Answer 1

* Factors affect perception of pain and pain response.

      * Previous experience with painful stimuli.

      * Age. (Adults can withstand more pain compared to children)

      * Gender.( Men can tolerate more pain compared to women).

      * Psychological factors. (Depression and anxiety leads to less pain tolerance)

      * Hereditory factors. (Genetic changes affect a persons pain perception.)

      * Life style.( Athletes have more pain tolerance compared to less exercise person).

* Mechanism of blocking pain impulses by opioids.

     * Opioids act by binding to the opioid receptors like mu,kappa,delta present

       in the central nerve system,peripheral nerve system and gastrointestinal tract.

     * This result in stimulation of opioid receptors and leads to decrease in the

        intracellular calcium.

    * Decrease in calicium leads to decrease release of neurotransmitters so the

       nociceptive receptors ( sensory receptors respond to painful stimulus)

       input blocked.

* Other methods reduce pain.

         * Relaxation therapy include therapeutic massage,physiotherapy help to

            reduce pain.

         * Cold application in painful area help to reduce pain by vasoconstriction.

         * Hot application can reduce pain by relax stiff joints and muscles.

         * Psychological support help to contol pain by reduce anxiety level.

         * Music therapy can control pain by reduce stress level of the patient.