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PAIN

MANAGEMENT

Bimo Kusumo Bhirowo


Unpleasant
Pain??
SUBYEKTIF

Morgan & Mikhail’s


Clinical Anesthesiology 6th Edition
Allodynia

Radiculopathy Analgesia

Paresthesia Anesthesia

Neuralgia
PAIN Anesthesia
Dolorosa

Hypesthesia Dysesthesia

Hyperpathia Hypoalgesia

Hyperesthesia

Morgan & Mikhail’s


Clinical Anesthesiology 6th Edition
Somatic Pain
Acute Pain

Visceral Pain

Morgan & Mikhail’s


Clinical Anesthesiology 6th Edition
1-6 bulan
Chronic Pain Nociceptive, neuropatic, campuran

Psikologis, lingkungan

Morgan & Mikhail’s


Clinical Anesthesiology 6th Edition
PAIN PATHWAY?

– Gu

GUYTON AND HALL Textbook of


Medical Physiology 12th Edition
1st
Order Neuron

Transduksi
in gs Schwann
En d
erve Cell Cell Body
e N
Fre
Transmisi
Na+

Inflammatory
Chemichal Dendrit Axon
Ex: Bradykinin
Prostaglandin

GUYTON AND HALL Textbook of


Medical Physiology 12th Edition
2 Order Neuron
nd

2nd Order Neuron Synaps

Glutamat

GUYTON AND HALL Textbook of


Medical Physiology 12th Edition
3 Order Neuron
rd

ThalamoCortical
Tract

Thalamus
(generate Pain)

C-Fiber ke Reticular System

Limbic Sleeping Disorder

GUYTON AND HALL Textbook of


Medical Physiology 12th Edition
Modalitas Pain Management
NSAID

Pain Acetaminophen
Intervensi

PAIN

Opioid Ketamine
Clinical Anesthesia Procedures of the
Massachusetts General Hospital
Multimodal Analgesia
Transduksi

Transmisi

Modulasi

Persepsi
Opioid

PAG : Periaqueductal Gray


MOR : mu Opioid Receptor

Goodman & Gilman’s


The Pharmacological Basis Of Therapeutics 13th Edition
Receptors

Morgan & Mikhail’s


Clinical Anesthesiology 6th Edition
Agonis

Goodman & Gilman’s


The Pharmacological Basis Of Therapeutics 13th Edition
Goodman & Gilman’s
The Pharmacological Basis Of Therapeutics 13th Edition
Goodman & Gilman’s
The Pharmacological Basis Of Therapeutics 13th Edition

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