anesthesia- analgesia review

4 steps of nociception

• transduction

• transmission

• modulation

• perception

transduction

mechanical, thermal, or chemical stimuli turned into electrical impulse

transmission

conduction of nerve impulses to spinal cord

modulation

• suppression or amplification of pain signal

• involves both excitatory and inhibitory neurotransmitters

benefits of pre emptive analgesia

• decreases wind up pain/ phenomenon

• decreases amount of general anesthesia

wind up leads to

• allodynia

• hyperalgesia

opioids

• 1st choice for pain

• work on 3 of 4 phases of nociception

3 properties of NSAID’s

• analgesia

• anti inflammatory

• antipyretic

COX-1

enzyme important for production of good prostaglandins

COX-2

enzyme important in production of prostaglandins that cause pain and inflammation

NSAID side effects

• gastric ulcers

• renal toxicity

• impaired plt function

• hepatic damage