慢性疼痛（PPT讲稿）Chronic Pain Again

Chronic Pain Again Dr Mc chu Anaesthesia and Intensive Care PWH

Chronic Pain Again Dr. MC Chu Anaesthesia and Intensive Care PWH

Agenda Remember the cases last time? Bear in mind the complexity of chronic pain Let's try to treat them

Agenda Remember the cases last time? Bear in mind the complexity of chronic pain Let’s try to treat them

Treatment principles Pain as a symptom Find the cause and fix it Pathology oriented Works well in acute pain Well accepted by patient and doctor

Treatment principles Pain as a symptom Find the cause and fix it Pathology oriented Works well in acute pain Well accepted by patient and doctor

Treatment principles Pain as a symptom Find the cause and fix it Works well here

Treatment principles Pain as a symptom Find the cause and fix it Works well here

Treatment principles Pain as a symptom Find the cause and fix it Does all headaches have a pathology?

Treatment principles Pain as a symptom Find the cause and fix it Does all headaches have a pathology?

Treatment principles Pain as a symptom Control the symptom Passive Long term effects and side effects Case specific What are the options?

Treatment principles Pain as a symptom Control the symptom Passive Long term effects and side effects Case specific What are the options?

Symptom control Medications Antipyretics (paracetamol) NSAID Opioids Antidepressants Anticonvulsants Steroids, muscle relaxants. etc

Symptom control Medications Antipyretics (paracetamol) NSAID Opioids Antidepressants Anticonvulsants Steroids, muscle relaxants, etc

Symptom control Paracetamol Effective in oa knees Amadio curr ther res 1983 Effectiveness Ibuprofen Bradley N. Eng. J Med. 1991 Safe and economical, NSAID sparing for elder Nikles am, j. Ther 2005

Symptom control Paracetamol Effective in OA knees Amadio Curr. Ther. Res. 1983 Effectiveness ~ Ibuprofen Bradley N. Eng. J. Med. 1991 Safe and economical, NSAID sparing for elderly Nikles Am. J. Ther. 2005

Symptom control Paracetamol Evidence in OA only Hepatic and renal toxicity do occur Medication induced headache

Symptom control Paracetamol Evidence in OA only Hepatic and renal toxicity do occur Medication induced headache

Symptom control Medications Antipyretics(paracetamol) NSAID Opioids Antidepressants Membrane stabilisers(anticonvulsants) Steroids, muscle relaxants. etc

Symptom control Medications Antipyretics (paracetamol) NSAID Opioids Antidepressants Membrane stabilisers (anticonvulsants) Steroids, muscle relaxants, etc