I. Definition of pain
Pain is a complex combination of physiological and psychological and other factors subjectively felt along with existing or brazing potential tissue damage. The emphasis on pain as a subjective sensation of the patient suggests that the assessment of pain intensity should be based on the patient’s own complaints.
II. Assessment of pain
Mild (1-3 points): tolerable pain, able to live normally and sleep basically undisturbed
Moderate (4-6 points): persistent pain, sleep is disturbed, analgesics are required.
Severe (7-10 points): persistent severe pain, sleep is seriously disturbed, analgesics must be used.
III. Common misconceptions about pain treatment
Myth 1: Analgesic treatment is sufficient as long as it can bring partial relief of pain.
1. Pain relief is the key to improve the quality of life of patients.
2.The minimum requirement of pain relief treatment is to achieve pain-free sleep.
3.The real sense of improving the quality of life of patients should include: pain-free sleep, pain-free rest and pain-free activities.
Myth 2: Long-term use of narcotic painkillers will lead to “addiction”.
”Addiction” is characterized by a persistent, unscrupulous craving for opioids, not for pain relief, but to achieve “euphoria. The medical use of opioids does not increase the risk of opioid abuse.
Myth 3: Taking high doses of opioids can be toxic.
There is no capped dose of opioids, and the appropriate dose for pain relief is the dose that provides adequate analgesia without intolerable side effects during the duration of action.
Myth 4: You should not use opioid painkillers as a last resort.
If pain is not effectively relieved for a long time, it will affect sleep, appetite, and reduce the patient’s resistance, thus giving the disease a chance to develop further. Pain can mostly be well controlled by oral medication.
Myth 5: The higher the dose of morphine, the more serious the disease
1, pain is a “subjective” feeling, with significant differences.
2, the same intensity of pain requires the same dose of painkillers may not be the same.
3.Some patients need high dose of morphine to achieve the purpose of pain control.
4, the dose of morphine can not reflect the severity of the disease, let alone estimate the length of survival.
Fourth, the prevention and treatment of opioid drug side effects
1, constipation: prophylactic medication, increase fluid intake, increase dietary fiber, if conditions allow, appropriate to participate in exercise.
2, nausea, vomiting: the first week of opioid drugs, such as nausea and vomiting, it is best to take antiemetic drugs at the same time, 4-7 days to relieve.
3, urinary retention: avoid using sedatives at the same time, avoid overfilling the bladder, and give the patient good time and space to urinate. The patient can be allowed to listen to the sound of running water or apply warm towels to the lower abdomen and catheterize if necessary.
4, respiratory depression: generally oral opioids rarely occur, during the drug, especially when taken outside the hospital, family members should observe the patient’s consciousness and respiratory condition on time, if the respiratory Q8 times / min, should promptly consult a doctor.
V. Key points for pain patients to take painkillers correctly
The first use of opioids should start with a low dose and gradually increase the dose. If the pain score is above 4, or the time to pain relief is shortened, an increase in dose should be considered. Give the medication on time, if there is an outbreak of pain give immediate release preparations, controlled/relaxed release preparations need to be swallowed whole and not chewed.
VI. How can pain patients participate in self-care?
1.If you feel pain do not wait for the health care provider to ask, you should take the initiative to present to them, even on weekends and evenings.
2. Keep a daily record of where your pain is, when it starts, when it is most intense, and under what conditions it can be relieved.
3. Learn to use the 0-10 numerical pain assessment scale to describe the intensity of pain.
4.Take your medication strictly according to your doctor’s prescription, remember how and when to take it, and report the side effects of your medication promptly.
5.Use the medication before the onset of pain, because the more severe the pain is, the less easily it can be controlled.
6.Non-medical measures may be effective for you, such as relaxation, deep breathing, massage, recalling some pleasant experiences, etc.
7.Participate in some rehabilitation groups, tell your friends about your confusion, experience and feelings, you can also learn something useful from them.
7.What should families pay attention to when giving medication to pain patients?
1.Know and understand which medications should be given on time and which should be given on demand, for example, those marked with “PRN” on the prescription are only needed when the pain is aggravated.
2. Give the medication to the patient on time to maintain a stable blood level and to ensure that the patient is pain-free for 24 hours.
3. Give the medication before the onset of pain, do not wait until the pain is unbearable, the more severe the pain is, the less easy it is to control.
4.Develop an appropriate dosing schedule, both to ensure accurate dosing intervals and to avoid sleep time as much as possible.
5. Do not stop the medication abruptly, some discomfort will occur if the medication is stopped suddenly, and the gradual reduction of the medication under the guidance of the doctor can avoid the occurrence of discomfort.