Download Acute Pain Management by Raymond S. Sinatra, Oscar A. de Leon-Cassasola, Eugene R. PDF

By Raymond S. Sinatra, Oscar A. de Leon-Cassasola, Eugene R. Viscusi, Brian Ginsberg

This textbook is written as a accomplished evaluation of acute ache administration. it truly is designed to steer clinicians via a magnificent array of other techniques to be had to them and to sufferers. within the final decade there was a flurry of curiosity within the quantity to which acute discomfort can develop into persistent ache, and the way we would lessen the occurrence of such chronicity. This evaluate covers a variety of remedies for discomfort administration, together with the anatomy of discomfort pathways, the pathophysiology of serious soreness, soreness evaluate, healing directions, analgesic strategies, association of ache prone, and the position of anesthesiologists, surgeons, pharmacists, and nurses in delivering optimum care. It additionally discusses using patient-controlled analgesia and the way this can or will not be potent and precious.

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J Pharmacol Exp Ther. 2004;309(3):869–878. 101. Muscoli C, Mollace V, Wheatley J, et al. Superoxide-mediated nitration of spinal manganese superoxide dismutase: a novel pathway in N-methyl-D-aspartate-mediated hyperalgesia. Pain. 2004;111(1–2):96–103. 102. Urban MO, Gebhart GF. Central mechanisms in pain. Med Clin North Am. 1999;83(3):585–596. 103. Marchand F, Perretti M, McMahon SB. Role of the immune system in chronic pain. Nature. 2005;6(7):521–532. 104. McLean Bolton M, Pittman AJ, Lo DC. Brain-derived neurotrophic factor differentially regulates excitatory and inhibitory synaptic transmission in hippocampal cultures.

3) The process of transmission describes synaptic transfer of noxious impulses from primary afferents to second-order cells in the dorsal horn. (4) Modulation describes inhibitory and facilitory effects of spinal interneurons on noxious transmission. (5) Descending inhibition refers to descending brainstem, midbrain, and cortical inhibitor nerve endings that supress pain transmission. (6) Cortical perception includes neocortical sites of pain localization and limbic centers responsible for emotional and suffering components of pain.

70 Brain imaging techniques have also been employed to characterize cortical sites of pain modulation. μ-opioid receptors are involved in regulating the experience of pain in specific thalamic and cortical regions. Zubieta and coworkers71 utilized PET scanning with the selective μ-receptor agonist carfentanil to evaluate sites of opioid uptake. They also studied whether opioid suppression of masseter muscle pain reduced metabolic activation in specific regions of the brain. They found that carfentanil binding at μ receptors uniquely reduced metabolic activity in cortical regions responsible for sensory and affective dimensions of pain.

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