Why do I feel pain?
The sensation of pain is a mechanism the body uses to avoid or limit harm; in other words, to protect itself. Upon feeling discomfort, the body acts in different ways to mitigate or eliminate it:
- Pain signal detectors, which indicate the presence of pain.
- Reflexes: rapid protective mechanisms; for example, quickly removing your hand when touching a hot surface.
- Stress: general alert mechanisms that prepare the body to act in the face of a threat. These impulses aim to alert the individual and initiate fight-or-flight behaviors to preserve bodily integrity.
- Location of pain or injury: perception of the place in the body that causes pain.
- Internal analgesia mechanisms: our body releases substances that allow us to reduce pain even when we have serious injuries.
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Pain classification
Pain is classified according to its origin or its persistence (how long it lasts).
Depending on the origin:
- Neuropathic pain: It is caused by an alteration or damage to the function of the central or peripheral nervous system. It is perceived as a tingling, burning, electric shock, or stabbing sensation.
- Visceral pain: It is caused by the activation of pain receptors in the thoracic cavity, abdomen, and pelvis. It is usually perceived as colic and is difficult to locate or describe.
- Somatic pain: It is caused by the activation of pain receptors present in tissues such as skin, mucous membranes, muscles, bones, and joints, in response to an inflammatory process. It is usually well-localized and varies in intensity depending on the injury.
Depending on persistence:
- sharp pain: It appears as a consequence of injuries and generally improves during the recovery process. It is usually intense and has a rapid onset, but is short-lived, lasting 2 to 3 weeks.
- Chronic pain: It is continuous, recurrent, and persists beyond the normal healing time.
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How to express pain?
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Post-surgical pain management
It is normal to experience pain after surgery or a procedure. This pain may even extend to areas near the wound. For this reason, it is important to follow your doctor's instructions for managing it.
Take your pain medication (analgesics) according to the schedule and dosage established by your doctor.
If, even after taking the medication, the pain does not subside and, on the contrary, increases or appears suddenly, consult your doctor.
Pain management in cancer patients
People with cancer are highly likely to experience pain. Early identification is crucial for intervention and to prevent disruption to daily activities.
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How do I express my pain?
Sometimes it's difficult to describe how much pain you're feeling. For this reason, it's recommended to use this scale, which can help you communicate your pain level to healthcare professionals so they can assist you.
Types of analgesia:
Patient-controlled analgesia
It refers to the use of a device that continuously delivers opioid analgesic, the doses of which can be controlled by the patient by means of a pulse oximeter.
How does the pulser work?
This device has a button that delivers medication when pressed. It is programmed by anesthesiologists to prevent medication overdose, making it a safe system for pain management.
Adverse effects and complications
- Nausea, vomiting, and dizziness.
- Itching in different parts of the body.
- Skin irritation.
- Constipation.
- Urinary retention.
- Difficulty breathing.
- Allergic reactions.
- Decreased blood pressure.
- Abdominal distension.
IMPORTANT:
- Inform your doctor when you feel pain and its characteristics: Intensity, duration, type (burning, stabbing, etc.), whether it radiates to other parts of the body, and whether it subsides with any medication or position.
- Please inform us of the medications you use daily.
- Take special care with the catheter when bathing or changing position. It must be constantly monitored and should only be removed by trained personnel.
Patient-controlled epidural analgesia
This refers to the use of a device that continuously delivers local anesthetic through a catheter. The doses can be controlled by the patient using a pulse oximeter.
How does the pulser work?
This device has a button that delivers medication when pressed. It is programmed by anesthesiologists to prevent medication overdose, making it a safe system for pain management.
What does an epidural catheter involve?
In this technique, the catheter is placed between the vertebrae, in the space where the nerves pass through to different areas of the body, with the aim of blocking the sensitivity of the surgical site: thorax, abdomen, bones, vascular, plastic and reconstructive surgery, etc.
How is it inserted?
- With the patient in a seated or side-lying position, a puncture is made in the lower back, after prior local anesthesia at the site to insert the needle.
- A flexible catheter is inserted through the needle, which will allow the passage of medication as indicated by Anesthesiology.
- The needle is removed and the catheter is secured.
- The medication is delivered via a pulse device.
- This catheter is removed between the 4th and 5th day after the procedure.
Adverse effects and complications
- Accidental puncture of a nerve or blood vessel and nerve injury.
- Headache, back pain, and pain at the puncture site.
- Infection, bruising, dizziness, and low blood pressure.
IMPORTANT:
- Although this medication allows walking, it is necessary to remain accompanied by the staff in charge.
- Inform your doctor when you feel pain and its characteristics: Intensity, duration, type (burning, stabbing, etc.), whether it radiates to other parts of the body, and whether it subsides with any medication or position.
- Please inform us of the medications you use daily.
- Take special care with the catheter when bathing or changing position.
- This must be constantly monitored and will only be removed by specialized personnel.
Regional anesthesia or blocks
Information for the patient and family
What does regional anesthesia or a block involve?
It consists of supplying local anesthetic, after sedating the patient, around the nerves responsible for the sensitivity of the area to be operated on (chest, abdomen, knee, shoulder, hip), by means of a puncture guided by ultrasound or electrical stimulation, which indicates the correct site of the application.
In patients with complex or painful procedures who therefore require several days of hospital stay, this block is performed continuously, through a catheter, by means of a pulsed device.
How does the pulse work?
This device has a button that delivers medication when pressed. It is programmed by anesthesiologists to prevent medication overdose, making it a safe system for pain management.
Benefits of regional anesthesia:
- It is safe and effective.
- It offers adequate pain control during and after surgery.
- It causes fewer side effects such as vomiting, nausea, and dizziness.
- It allows for a quick recovery, as well as resuming the eating routine.
- It is an alternative to general anesthesia (in some cases).
Adverse effects and complications:
Frequent:
- Pain at the puncture site.
Uncommon:
- Nerve injury.
- bruises
- Infection.
- Seizures
- Heart disorders.
- Difficulty breathing.
Recommendations and care:
- Take care when walking and seek assistance, as your limbs may have reduced sensation, feel numb, tingly, or larger than normal.
- Avoid using the support points of the limbs: elbows, heels and fingers.
- Protect the operated limb from extreme temperatures and sharp objects.
- Take the medications prescribed by your doctor to avoid feeling pain.
Go to the emergency room if you experience:
- Continuous bleeding, foul odor, or discharge from the wound.
- Fever.
- Redness or warmth in the skin around the wound.
- Purple extremity.
- Pain that does not improve with medication.
IMPORTANT:
- Inform your doctor when you feel pain and its characteristics: intensity, duration, type (burning, stabbing, etc.), whether it radiates to other parts of the body, and whether it subsides with any medication or position.
- Please inform us of the medications you use daily.
- Take special care with the catheter (if you have one) when bathing or changing position.
- This must be constantly monitored and will only be removed by specialized personnel.
Pain management after cesarean section
Information for the patient and family
Spinal anesthesia with morphine is used to control pain after a cesarean section. This is a strong opioid medication used to treat pain, and its effect lasts for 24 hours in this case.
Why is it used?
Because this procedure is performed on patients with changes in their body caused by pregnancy, the intensity of postoperative pain is strong during the first two days and requires special management, which allows the patient to resume their daily routine, minimizing the risks associated with prolonged bed rest and promoting interaction between the mother and the newborn.
How is it done?
This medication is administered prior to the cesarean section, through a puncture in the lower part of the spine with a thin needle, while the patient is in a sitting or side-lying position.
Adverse effects:
- Nausea and vomiting.
- Skin itch.
- Numbness.
- Urinary retention.
- Low blood pressure.
- Decreased respiratory rate.
IMPORTANT
- Inform your doctor when you feel pain and its characteristics: intensity, duration, type (burning, stabbing, etc.), whether it radiates to other parts of the body, and whether it subsides with any medication or position.
- Inform us about the medications you use daily.
