الفهرس | Only 14 pages are availabe for public view |
Abstract The main role of the anaesthetist is to enable patients to undergo surgical and other painful or uncomfortable procedures without pain or distress. Although , this is almostly acheived during the operation, the pain and discomfort which are present after surgery are usually less effectively relieved. The lack of interest in postoperative pain is probably associated with the fact that pain after ‘urgery improves rapidly ; Rarely postoperative pain may be severe to cause autonomic changes equal to that in vasovagal attacks, but usually , only sweating and nausea are present . The effects of postoperative pain are largely due to psychological excitation causing anxiety. The most obvious motive , therefore , for relieving postoperative pain is the humanitarian one. Pain is a protective mechanism from Allah, it occurs wherever any tissues are being damaged to cause the indivdual to react or to remove the painful stimulus. Postoperative pain has two components, acute superfical fast pain from the wound and slow delayed deep chronic pain which originate from deep tissues, so pain impulses are transmitted by different fibres to enter the spinal cord and end on the brain reticular formation in case of deep pain while fast pain continues to cerebral cortex to aid in localizing the pain. Adequacy of pain relief can be assessed by using one of the simpler unidimentional scales as visual analogue scale and other subjective and objective methods as patient ability to move,respiratory functions,blood glucose level, pulse, blood pressure and other endocrine functions can give an idea about the stress of pain; Recently with the great advances in the understanding of internal opioids, the measurement of B-endorphin can help in knowing the degree and type of analgesia. |