Acute pain management

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Chapter one: physiology and psychology of acute pain

1. Afferent nocioceptive pathways, dorsal horn, peripheral and central mechanisms, neuromodulatory systems, supraspinal mechanisms
2. Nocioceptive pain
3. Visceral pain
4. Neuropathic pain :
   1. Consequences of peripheral nerve injury, spinal cord injury and deafferentation. Recognition of neuropathic pain
5. Influence of therapy on nocioceptive mechanisms
6. Basic psychology relevant to pain management

Chapter two: assessment and measurement of acute pain and its treatment

1. Measurement of pain including monitoring of acute pain and pain relieving methods

Chapter three: provision of safe and effective acute pain management

1. Organisation and objectives of an acute pain service

Chapter four: systemically administered drugs

1. Application of pharmacological principles to the pain control: conventional analgesics and adjuvant analgesics; side effects; problems of drug dependency and addiction
2. The analgesic ladder
3. Opioids: drugs and mechanisms
4. Simple analgesics: drugs and mechanisms
5. Non-steroidal anti-inflammatory agents: drugs and mechanisms
6. Inhalational analgesia

Chapter five: regionally and locally administered drugs

1. Local anaesthetic agents: drugs and mechanisms
2. Principles of neural blockade for pain management
   1. Peripheral nerve blocks
   2. Plexus blocks
   3. Epidural blocks
   4. Subarachnoid blocks

Chapter six/seven: routes/techniques of systemic drug administration

1. Opioids: intramuscular, intravenous infusion, intravenous PCA , subcutaneous PCA, epidural, intrathecal

Chapter eight: non-pharmacological methods

1. Non-pharmacological methods of pain control. The principles of stimulation induced analgesia: transcutaneous electrical nerve stimulation and acupuncture .

Chapter nine: specific clinical situations

E.g. Specific Medical Conditions – no specific reference in CCT II or III except in chronic pain setting

Chapter ten: specific patient groups

1. Specific clinical groups: children and neonates, elderly, impaired consciousness, intensive care, handicapped, Opioid tolerant patient