DEFINISI NYERI

Pengalaman sensorik dan emosional yang tidak menyenangkan akibat kerusakan jaringan, baik
aktual maupun potensial, atau yang digambarkan dalam bentuk kerusakan tersebut
Definisi Nyeri

• Nyeri Fisiologik
Nyeri yang timbul akibat berbagai stimuli yang tidak menimbulkan kerusakan jaringan

• Nyeri Nosiseptif / Nyeri inflamasi

Nyeri yang timbul akibat berbagai stimuli yang menimbulkan kerusakan jaringan

• Nyeri Neuropatik
Nyeri yang didahului atau disebabkan oleh lesi atau disfungsi primer pada sistem saraf

• Nyeri Psikogenik/Nyeri Fungsional

Nyeri di mana faktor psikogenik dominan, tanpa kerusakan jaringan dan sistem saraf sebagai
penyebab
Stimulus yg membangkitkan nyeri

• Kulit  injury jaringan ok tusukan, sayatan, panas dan dingin

• Lambung/usus  inflamasi mukosa, spasma otot polos, perlengketan
• Otot-otot lurik  iskemik
• Otot skletal kontraksi terus menerus
• Otot jantung  iskemik
• Sendi  inflamasi, saline hipertonik
• Arteri  distensi, pulsasi berlebihan
• Pereganagan arteri dan mening (sakit kepala)

The Process of Pain

• The process of pain  four phases :
1. Transduction
2. Transmission
3. Perception
4. Modulation
 1. Transduction
• Conversion of chemical information at cellular level  electrical inpulses that move
toward the spinal cord
• Begins when injured cells release chemicals such as prostaglandin, Substance P,
bradykinin, histamin, and glutamat excite nociceptor in the skin, bone, joints, muscles,
and internal organs

2. Transmission
• The phase during wich stimuli move from the peripheral nervous system  brain
• Occurs when peripheral nociceptor form synapses with neurons within the spinal cord
that carry pain inpulses via fast and slow nerve fibers ( A delta and C fiber ).
• With the help of substance P, pain impulses move higher level in the brain RAS,
thalamus, cerebral cortex and lim
• when pain impulses reach the thalamus  two responses occurs
First  the thalamus transmits the message to the cortex, where the location and
severity of the injury are identified
Second  it notifies the nociceptor that the message has been received and that
continued transmission is no longer necessary.

3. Perception
• occurs when the pain threshold (point at wich sufficient pain transmitting stimuli reach the
brain) is reached.
• Pain thresold tend to be the same among healthy people, but each person tolerates the sensation
of pain diffrently
• Pain tolerance (amount of pain a person endures) is influence by genetics, behaviors
(culture,gender,age) and other biopsychosocially  anxiety level, past pain experiences, and
emotional dispotition

4. Modulation
• The last phase of pain impulse transmission during wich the brain interacts with the
spinal nerves in a donward fashion to subsequently alter the pain experience.
• At this point, the release of pain-inhibiting neurochemicals reduces the painful sensation
( endogenous opioids, GABA).

Klasifikasi Nyeri Neuropatik

I. Berdasarkan intensitas nyeri

II. Berdasarkan penyebab
III. Berdasarkan lokasi
IV Berdasarkan mekanisme
1. Berdasarkan intensitas nyeri
• Pengukuran menggunakan skala nyeri
1. Numeric Pain Intensity Scale (NPIS)
1 – 3 Nyeri ringan
4 – 6 Nyeri sedang
7 – 10 Nyeri berat
2. Visual Analog Scale
3. Faces Pain Rating Scale (untuk anak)
III. Berdasarkan lokasi

1. Nyeri neuropatik sentral

2. Nyeri neuropatik perifer