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15 Cards in this Set
- Front
- Back
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Unpleasent sensory or emotional experience which occurs as a result of actutal or potential tissue damage or described in terms of it
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Pain
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Acute pain
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Mainly Nociceptive
can be neuropathic < 3-6 months |
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Chronic pain
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Mixed but mainly neuropathic
>3- 6 months psycological issues |
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Treatment modalities
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1. Pharmacological
2. Physical 3. Neurobehavioural 4. Interventional |
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Pharmacological
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NSAIDS/Paracetamol/Opioids
Tricyclics Antiepileptics alpha 2 agonist opioids Na channel blockers |
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Pain scales
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NRS (0-10)
VRS (mild-mod-severe) VAS (0-100mm) McGill pain questionaure Faceies scale Brief pain inventory Memorial pain assessment Neuropathic pain scale The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) |
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Anterior to Stellate ganglion
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Skin, SC tissue
SCM Carotid sheath |
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Posterior to Stellate ganglion
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Longus colli muscle
Vertebral vessels Bracheal plexus sheath Scalenus anticus neck of first rib and C7 |
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Medial to Stellate ganglion
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C7 body
esophagus Thoracic duct |
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Contraindications
for SG block |
Coagulopathy
Glaucoma Bradycardia Recent MI |
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Celiac plexus relationship
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Aorta posteriorly
IVC lateraly Pancreas anteriorly |
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Celiac Plexus nerves
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Greater T5-T9
Lesser T10-T11 Least T11-12 |
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Celiac plexus
Doses |
Benign:
10+10 ml 0.5% ropivacaine Malignant: 5ml 6% phenol+5 ml 0.5% ropivacaine on each side |
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High freqency TENS
(100-200HZ) |
Ab low thresh hold fibres
low intensity stimulation Inc dynorphins in DH , keppa Short lived |
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Low frequency TENS
(2-4HZ) |
Ad high thresh hold fibers
high intensity stimulation Accupunture inc metenkphline in DH , mu Last days to months |
