painManagementForDummies - Kutaiba Tabbaa M.D Director Pain...

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Kutaiba Tabbaa M.D. Director, Pain Management Clinic University Medical Center Associate Professor of Anesthesia University of Arizona Tucson, Arizona
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What’s the definition of pain?
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Pain is a Sensory and Emotional experience associated with tissue damage or described in terms of such damage (I.A.S.P.)
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The Pain Pathways and Mechanisms
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Pain Pathways Frenchman Rene Descartes, De humine textbook
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Fibers C Fibers
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Axon Reflex Np : Neuro-peptides, BV : Blood Vessels
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Physiology of the dorsal horn of the spinal cord
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Hyperalgesia And pain Threshold in humans
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Pain Management in the late 18 th century Barker M.D .
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Different Pain management Modalities
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Pre-emptive Analgesia Pre-emptive analgesia can be achieved by: local anesthetic infiltration of the skin Effective dose of systemic opioids Systemic nonsteroidal anti-inflammatory drugs (NSAIDs) Neuroaxial opioids or local anesthetic Peripheral nerve blocks
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Patient Controlled Analgesia PCA 1. Increase patient satisfaction 2. Decrease side effects and complications 3. Decrease sedation 4. Decrease total amount of daily opioids 5. Avoid Basal rate in the Elderly 6. PCA Flowsheets
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Regional analgesia
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Isolated Extremity Injury
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Brachial plexus Anatomy
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Infraclavicular Approach
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