Analgesics, Case Reports and Obstetrical Pain

by Brian Warriner, MD

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    So, hello ladies and gentlemen. This is a continuation of our ongoing series of lectures on Anesthesiology. And this particular lecture is a continuation of the Management of Pain, which we started in the last lecture. We're going to spend some time in this lecture talking about the many other forms of medication that are used in management of pain. We're going to talk about three patients and how one would go about managing their pain. And then we're going to end with a discussion of Obstetrical Analgesia and how we manage pain during obstetrical care. So, these are some of the drugs we use. And these are Classes of Drugs. There's Opioids, which we've already talked about. Non-steroidal anti-inflammatory drugs, we've talked about. We're going to talk a little bit about Tricyclic antidepressants, Serotonin-norepinephrine reuptake inhibitors, Anti-convulsants, NMDA receptor antagonists, Alpha2 - agonists, 5HT1 - agonists for migraine, and then we're going, we've already talked about Nitrous oxide as an analgesic. We won't come back to that. So opioids, as I've mentioned, act on the mu-receptor in the brain and spinal cord to produce both effects, and unfortunately side-effects. And the side-effects are common. Respiratory depression in higher doses. Nausea and vomiting in very low doses. Constipation, extremely common. Sedation, very common. Dizziness. Sometimes euphoria, but the majority of people have Dysphoria, which is the opposite of euphoria. Instead of feeling happy, they just feel generally lousy. Confusion, muscle rigidity, pruritus are also potential complications. These drugs are ideal for managing acute pain, but are often ineffective in chronic pain and lead to dependence, as we've talked about. We've already talked about tolerance and physical dependence. They can lead, of course, to addiction in those people who are susceptible. Remember what I said earlier, physical dependence...

    About the Lecture

    The lecture Analgesics, Case Reports and Obstetrical Pain by Brian Warriner, MD is from the course Anesthesia. It contains the following chapters:

    • Opiate Receptor Agonists
    • Non-Steroidal Anti-Inflammatories
    • Anti-Depressants
    • Anticonvulsants
    • N-Methyl D-Aspartate Receptor Antagonists
    • Local Anesthetics
    • Case Reports
    • Obstetrical Pain

    Included Quiz Questions

    1. Interfere with platelet function and can cause renal damage.
    2. Act upon receptors in the central nervous system.
    3. Can be used as amnestics.
    4. Are used in the treatment of gastric hemorrhage.
    1. Allows the patient control over the administration of analgesics to control their pain.
    2. Frequently causes opioid ovedose.
    3. Is a technique to deliver analgesics directly into the central nervous system.
    1. Severe, intermittent and unique to each pregnancy.
    2. Similar to a toothache – continuous and made worse by movement.
    3. Is similar in every pregnancy of a given woman.
    4. Usually easily controlled by non-medical means.

    Author of lecture Analgesics, Case Reports and Obstetrical Pain

     Brian Warriner, MD

    Brian Warriner, MD

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