By Sinatra R.S., Ginsberg B., Viscusi E.
This textbook presents an summary of ache administration helpful to experts in addition to non-specialists, surgeons, and nursing employees.
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Extra info for Acute Pain Management
Craig AD. Pain mechanisms: labeled lines versus convergence in central processing. Ann Rev Neurosci. 2003;26:1–30. 71. Zubieta JK, Smith YR, Bueller JA, et al. Regional mu opioid receptor regulation of sensory and affective dimensions of pain. Science. 2001;293(5528):311–315. 72. Grachev ID, Fredrickson BE, Apkarian AV. Abnormal brain chemistry in chronic back pain: an in vivo proton magnetic resonance spectroscopy study. Pain. 2000;89(1):7–18. 73. Besson JM. The neurobiology of pain. Lancet. 1999;353(9164): 1610–1615.
59 With regard to expression, polymorphisms of OPRM1 neither influence the conformation of the external binding site nor affect the binding affinity of opioid ligands. 10: Opioid receptors activate specific G proteins that decrease neuronal excitability either by inhibiting K+ ion conductance or decreasing intracellular cAMP. 12 Nalini Vadivelu, Christian J. Whitney, and Raymond S. Sinatra sensitivity, incomplete cross tolerance, and improved efficacy associated with opioid rotation. The modulatory effects of NE are mediated by activation of postsynaptic α-adrenergic receptors.
In addition, severe muscle spasm and accumulation of lactic acid may further worsen some aspects of acute pain. Synapses with anterolateral cells are responsible for noxious segmental sympathetic responses, including vasoconstriction, vasodilation, and effects on gastrointestinal and cardiac function. These important “fight or flight” responses increase perfusion to heart, brain, and skeletal musculature, whereas reducing blood flow and hemorrhage at the site of injury. (Please see Chapter 2, Pathophysiology of Acute Pain).
Acute Pain Management by Sinatra R.S., Ginsberg B., Viscusi E.