Scribd Logo
Upload

Welcome to Scribd!

  • 125 views

    Pain Management: Dr. Surya Bayu Prajayana, M.Biomed, Sp. OT

    Uploaded by

    OgizWara
    Pasien sudah bisa berjalan dengan bantuan walker. VAS 2/10. Diperbolehkan pulang. Tanggal 13 November 2015 Pasien diperbolehkan pulang. VAS 1/10

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Pain Management: Dr. Surya Bayu Prajayana, M.Biomed, Sp. OT

    Uploaded by

    OgizWara
    125 views22 pages
    Pasien sudah bisa berjalan dengan bantuan walker. VAS 2/10. Diperbolehkan pulang. Tanggal 13 November 2015 Pasien diperbolehkan pulang. VAS 1/10

    Original Description:

    paint manajemen

    Original Title

    Pain Management

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Pasien sudah bisa berjalan dengan bantuan walker. VAS 2/10. Diperbolehkan pulang. Tanggal 13 November 2015 Pasien diperbolehkan pulang. VAS 1/10

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    125 views22 pages

    Pain Management: Dr. Surya Bayu Prajayana, M.Biomed, Sp. OT

    Uploaded by

    OgizWara
    Pasien sudah bisa berjalan dengan bantuan walker. VAS 2/10. Diperbolehkan pulang. Tanggal 13 November 2015 Pasien diperbolehkan pulang. VAS 1/10

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 22

    PAIN MANAGEMENT

    Dr. Surya Bayu Prajayana, M.Biomed, Sp. OT


    Definition

    “Pain is an unpleasant sensory and


    emotional experience associated with
    actual or potential tissue damage or
    described in terms of such damage.”

    International Association for the Study of Pain. Pain. 1979;6:249.


    Pain Classification

     Pain may be classified into two varieties:


    acute and chronic.

     As a rule, postoperative pain is


    considered a form of acute pain,
    although it may become chronic if it is not
    effectively treated.
    Pain Sensitization
    10
    Hyperalgesia Normal
    8 Pain
    Response
    Pain Intensity

    6 Injury
    Hyperalgesia –
    heightened sense of pain
    4
    Allodynia in response to noxious
    stimuli
    2 Allodynia – pain resulting
    from normally painless
    stimuli
    0
    Stimulus Intensity

    Adapted from Gottschalk A et al. Am Fam Physician. 2001;63:1980.


    Example of Measurement Tool
    for Assessing Pain

    Visual Analog Scale (VAS)

    No pain Pain as Bad as it could


    possibly be

    Carr DB, et al. AHCPR Pub. No. 92–0032. 1992.


    Example of Measurement Tool
    for Assessing Pain

    Carr DB, et al. AHCPR Pub. No. 92–0032. 1992.


    Analgesic Options for Acute Pain Management

     Opioid analgesics
     Nonopioid analgesics
     acetaminophen
     tramadol

     anti-inflammatory agents

     Combination analgesic products


     Local anesthetics, nerve, neuraxial blocks
    Opioid Analgesics

     Binding at , , , receptors
     Highly efficacious
     May be used in PCA
     May be combined with anti-inflammatory agents
     Effects may be reversed
     Side effects common

    Fishman SM, Borsook D. In: Benzon HT, et al, eds. Essentials of Pain Medicine and Regional Anesthesia; 1999:51–
    54.
    Adverse Effects of Opioids

     CNS depression, sedation


     Respiratory depression
      GI motility, nausea, vomiting
     Urinary retention
     Pruritus
    Case 1

    Identitas
    Nama : Tn WB
    Jenis Kelamin : Laki-laki
    Umur : 50 Tahun.
    No Cm :13025021
    Alamat : Denpasar
    Status : BPJS
    Ruang Rawat : Angsoka
    Diagnosis : MM
     ANAMNESIS.
     Pasien mengeluh nyeri seluruh tubuh dan lemah. Sebelumnya telah
    menjalani kemoterapi dan radioterapi.

     PEMERIKSAAN FISIK.
     BB: 45 kg; TB: 158 cm; T : 36,5oC.
     SSP : kompos mentis.
     Respirasi : RR: 16 x/mnt, vesikuler kanan kiri, rhonkhi dan
    wheezing tidak ada.
     Kardiovaskuler : TD : 110/70 mmHg. HR 88 x/mnt, S1 & S2
    reguler, tidak ada murmur.
     Gastrointestinal : Bising usus normal. Distensi tidak ada.
     Urogenital : dalam batas normal
     Musculoskeletal : dalam batas normal
    Tanggal 13 Februari 2014
    Pasien MRS, renacana perbaikan KU. Hb : 7,8 g/dL. Pro
    tranfusi WB 3kolf. VAS 8 / 10. Diberikan Fentanyl patch
    25 mcg / jam

    Tanggal 14 Februari 2014


    Pemberian transfusi darah. VAS 6 / 10

    Tanggal 17 Februari 2014


    Pasien diperbolehkan pulang. VAS 5 / 10
    Case 2

    Identitas
    Nama : Ny. NR
    Jenis Kelamin : Perempuan
    Umur : 55 Tahun.
    No Cm :13025021
    Alamat : Karangasem
    Status : Umum
    Diagnosis : Post Hemiarthroplasty Bipolar
     ANAMNESIS.
     Pasien terjatuh dirumah dan mengeluh nyeri panggul kanan. Sudah
    dilakukan hemiarthroplasty Bipolar.

     PEMERIKSAAN FISIK.
     BB: 50 kg; TB: 155 cm; T : 36,2oC.
     SSP : kompos mentis.
     Respirasi : RR: 18 x/mnt, vesikuler kanan kiri, rhonkhi dan
    wheezing tidak ada.
     Kardiovaskuler : TD : 120/80 mmHg. HR 80 x/mnt, S1 & S2
    reguler, tidak ada murmur.
     Gastrointestinal : Bising usus normal. Distensi tidak ada.
     Urogenital : dalam batas normal
     Musculoskeletal : dalam batas normal
    Tanggal 8 November 2015
    Pasien BPL. VAS 5/10. Diberikan Tramadol -
    Acetaminofen

    Tanggal 11 November 2015


    VAS 3/10

    You might also like