Blog#13

DEFINISIE

Pyn is ʼn onaangename sensoriese en emosionele ervaring wat gepaardgaan met

werklike of potensiële weefselskade = subjektiewe ervaring

Die persepsie van pyn word beïnvloed deur die pasiënt se gemoedstoestand,

moraal/moed en die betekenis wat die pyn vir die pasiënt het

AKUTE VS CHRONIESE PYN

AKUUT: Vinnige pyn

- Agv skade veroorsaak deur ʼn besering en duur gewoonlik ʼn kort tyd. Bv. ʼn

operasie kan akute pyn veroorsaak. Die pyn hou op wanneer die wond

genees. Intussentyd sal pynstillers gewoonlik die pyn onder beheer hou.

CHRONIES : Stadige pyn

- Pyn wat veroorsaak word deur veranderinge aan die senuwees en duur voort

lank nadat die besering of behandeling verby is, kan wissel van matig tot erg.

Chroniese pyn kan moeilik wees om te behandel, maar pynstillers asook

ander pynbeheermetodes kan dit dikwels suksesvol beheer.

Fast-sharp pain pathway and slow-chronic pain pathway.

Fast sharp: Mechanical or thermal pain stimuli- Peripheral nerves- Aδ fibres- 6-

30m/sec – spinal cord – neospinothalmic tract – lamina I of dorsal horn – long fibres

- thalamus without interruption - basal areas of brain and somatosensory cortex.

GLUTAMATE – specific location

Slow-chronic: Chemical or persistent mechanical and thermal. - C Fibres – 0.5-

2m/sec. Pain grows over time. – paleospinothalmic tract- spinal cord. Glutamate and

Substance P – lamina II and III of dorsal horn – short fibres – lamina V – brainstem

(medulla, mesencephalon or pons- 1/10th pass to thalamus – short fibre neurons to

thalamus- hypothalamus and basal regions of brain. – pain to non-specific area ex.

arm.

Pain perception is of lower centers – interpreting pain quality is cortex.

Places where the nerves terminate in thalamus and brain stem = arousal system =

patient can’t sleep.

DEURBRAAKPYN

• Pyn wat voorkom voor die volgende geskeduleerde dosering. Dus

onvoldoende dosering.

• Indien die pasiënt gereeld pynstillers neem, maar steeds pyn met tye ervaar,

laat die dokter weet.

TIPES KANKERPYN

1. Senuweepyn

2. Beenpyn (somatiese pyn)

3. Sagte weefselpyn (visserale pyn)

4. Spookpyn

5. Verwysde pyn

Nerve pain is caused by pressure on nerves or the spinal cord, or by damage to

nerves. It is also called neuropathic pain. People often describe nerve pain as

burning, shooting, tingling, or as a feeling of something crawling under their skin. It

can also occur after other cancer treatments such as radiotherapy or chemotherapy.

Bone pain : The cancer cells within the bone damage the bone tissue and cause the

pain. People often describe this type of pain as aching, dull or throbbing.

Soft tissue pain from a body organ or muscle. For example, you may have pain in

your back caused by tissue damage to the kidney. You can't always pinpoint this

pain, but it is usually described as sharp, cramping, aching, or throbbing.

Phantom pain in a part of the body that has been removed. For example, pain in an

arm or leg that has been removed due to sarcoma or osteosarcoma. Or pain in the

breast area after removal of the breast (mastectomy). Phantom pain is very real and

people sometimes describe it as unbearable.

Referred pain from an organ in the body may be felt in a different part of the body.

This is called referred pain. For example, a swollen liver may cause pain in the right

shoulder, even though the liver is under the ribs on the right side of the body. This is

because the liver presses on nerves that end in the shoulder.