Pain management of non pharmacology

The mechanism of pain is simply starts from the transduction of stimuli due to tissue damage in the sensory nerves to electrical activity and then transmitted through myelinated A-delta nerve fibers and non-myelinated nerve C into the spinal cord dorsal horn, thalamus, and cerebral cortex. Electrical impulses are perceived and discriminated against as the quality and quantity of pain after a modulation along the peripheral nerves and central nervous system. Stimuli that can evoke pain may be mechanical stimuli, temperature (hot or cold) and chemical agents that are released due to injury / inflammation.

Abstract

Pain is a sensory and emotional experience discomfort as a result of actual or potential tissue damage connected. One reason to seek medical treatment.
Because the nurse as much of their time interacting with patients complaining of pain compared with other health professions, the nurse must understand the psychology physiology and consequences of acute and chronic illness, and methods to overcome the pain. Nurses face the painful case of patients with various ways including acute action, OPD, and long term care at home. Then the nurse also need to know in theory and practice to assess pain and its effect on patients, pain management to implement and evaluate the effectiveness of this strategy.
1. Pathophysiology pain
2. Types of pain
3. Pain management of non pharmacology
4. Indications and contraindications

The effects of pain
1. Acute effect on pulmonary, cardio vascular, gastrointestinal, endocrine, system immunology
2. Chronic pain affects depression and disability

Chemical mediators of pain
1. Prostaglandins, histamine, bradikinine, acetylcholine, all chemical substances in the body of this effect increases the sensitivity of pain
2. Enkephins and endorphins, chemicals in the central nervous system works to reduce and inhibit the transmission and pain perception
1. The existence of enkephalins and endorphins to explain why everyone felt the difference in pain levels with stimulated by the same stimulus, the excess of endorphins to feel a little pain when compared to a little womb endorphisnya.
2. The classic teory gate control of pain (Wall, 1978)
Interconnected between the stimulus pain with the sensation of another, which blocks / inhibits pain stimuli
3. Descending control system
Fiber system originating from the bottom and the midportion of the brain (especially in aqueductal dray matter) and out into the fiber nerves in the spinal cord dorsal horn. This system in addition to actively prevent the transmission of pain stimuli, as endophrins role. The process of cognition can stimulate endorphin production didescending control system. Effectiveness of the system is illustrated by the effects of distraction. For example, visitors or favorite TV distraction can increase the activity in the descending control system. Thus, patients may visitor arrivals will not complain because the activity of descending pain control system that will withstand the pain. Instead the effect of depression is inversely proportional to distraction, because it lowers the activity of descending control systems and improve the perception of pain.
Assessment
The wrong perception of pain
1. Someone will easily addicted to pain medication
2. Patients who are good who avoid pain medication or do not complain of pain
a. Scale to assess pain. (Ganbar 12-4)
To avoid the subjectivity of nurses and doctors
b. Ask for an explanation of the patient about the pain:
> The intensity of pain; example, small, medium, very. 0-10 scale
> Characteristics of others; location, duration (minutes, hours, days), rhythm (continuous, sometimes), quality (sharp pain, burning pain)
> Factors that could nenurunkan pain (movement, bending)
> Ill effects on daily activities (lack of sleep, decreased appetite and work)
> Pasen Attention to pain (body image change)
c. Using a visual analogy images and face images. (For children)
Factors that influence the pain response
1. Past experience
2. Anxiety and depression
3. Culture and ethnicity
4. Age
5. Placebo effect
The types of pain:
1. Acute Pain
2. Chronic Pain
3. cancer pain


 The role of nurses in pain management.
Nurses help ease the pain of patients with non pharmacology and pharmacology and actions, assess the effectiveness of such measures. Monitor side effects, for some patients, outcomes or targets to be achieved is to stop the pain. For others it may just lower the intensity, duration, and frequency of pain and reduce the negative effects and illness. For example, pain interferes with a person's appetite and sleep patterns, for this case, the main purpose, of this problem is increasing good nutrition and sleep patterns effectively . Interfere with quality of life of chronic pain patients, especially the world of work and interpersonal relationships. This Goal is increasing productivity and interpersonal relationships.
Nurse-patient relationship.
1. Patient-nurse relationship is positive is the key to controlling the patient's pain.
2. Nurse-patient relationship is positively marked by mutual trust and empathy
3. Gives an explanation of pain control at home and avoid side effect.
> Helping daily living activities
> Controlling the anxiety associated with pain

Pain management strategies
1. Non pharmacology pain
Although a powerful pain medication for pain relief, but not the only way, many other ways that can be taken with a more minimal side effects.
a. Cutaneous stimulation and massage
The gate control theory of pain aims to stimulate the fibers of non-transmission of pain sensations that can block or reduce transmission of pain impulses-impulses. Some pain management non pharmacology including rubbing the skin, warm and cold compress is based on the theory of the stretcher. Massage also produces a sense of comfort due to make the muscles relax.
b. Ice and warm therapy

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