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Pain Management Notes

The document discusses pain management, highlighting considerations for epidural catheters and respiratory concerns related to hypercarbia. It outlines various types of pain, pharmacological interventions, and the importance of pain assessment, emphasizing the role of nurses in advocating for pain relief. Additionally, it addresses complications of poorly controlled chronic pain and the use of equianalgesia to prevent opioid overdose.

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strideformore
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41 views2 pages

Pain Management Notes

The document discusses pain management, highlighting considerations for epidural catheters and respiratory concerns related to hypercarbia. It outlines various types of pain, pharmacological interventions, and the importance of pain assessment, emphasizing the role of nurses in advocating for pain relief. Additionally, it addresses complications of poorly controlled chronic pain and the use of equianalgesia to prevent opioid overdose.

Uploaded by

strideformore
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Pain Management and Related Conditions

Epidural Catheter Considerations


• Risk: ↑ Risk of epidural hematoma with antithrombotic therapy.

• Signs/Symptoms:
- Back pain
- Sensory and motor dysfunction of limbs
- Bladder and bowel abnormalities

Respiratory Concerns

Hypercarbia (↑ CO₂ in blood)


• Causes:
- Hypoventilation
- COPD
- Sleep apnea

• Signs/Symptoms:
- SOB (shortness of breath)
- Dizziness
- Headache
- Confusion
- Flushed skin
- Fatigue

• Effects:
- Respiratory acidosis
- Coma
- Panic attacks
- Cardiovascular issues
- Seizures

Pain Types and Management

Types of Pain
• Nociceptive Pain: Caused by noxious stimuli

Pharmacological Interventions
• Fentanyl Patch:
- Reapply every 48–72 hours
- Avoid heat over patch: Can ↑ release of medication → risk of overdose
• Corticosteroids:
- Must be tapered slowly to avoid adrenal crisis

• NSAIDs (e.g., COX-2 Inhibitors):


- Block prostaglandin formation → stop pain transduction

• EMLA Cream (Local Anesthetic):


- Eutectic mixture or emulsion
- Apply 30 minutes prior to procedure

• Lidocaine 5% Patch:
- Approved for postherpetic neuralgia

Chronic Pain
• Examples: Chronic benign pain (e.g., back pain)

• Complications of poorly controlled pain:


- Anxiety
- Depression
- Impaired mobility

Neuropathic Pain
• 1st Line Analgesics:
- Gabapentin and Pregabalin (Anticonvulsants)

Pain Assessment Considerations


• Sleeping ≠ absence of pain

• Vital signs may change with pain but are the least sensitive indicator

Opioid Use and Equianalgesia


• Equianalgesia:
- Difference in potency between oral and IV morphine
- Prevents opioid overdose
- Dose and frequency tailored to patient response

• Nurse’s Role: Advocate for additional pain relief as needed

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