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Anestesia en México
On-line version ISSN 2448-8771Print version ISSN 1405-0056
Abstract
GARCIA-ANDREU, Jorge. Manejo básico del dolor agudo y crónico. Anest. Méx. [online]. 2017, vol.29, suppl.1, pp.77-85. ISSN 2448-8771.
Pain is the leading cause of medical consultation. The economic cost of the pain is “brutal”. Only in the United States, in 2010, the total cost is estimated between $560 and $635 billion. There are four basic processes of nociception: transduction, transmission, modulation and perception, in each of which the pain can be treated. Faced with a noxious stimulus or tissue damage, a number of neurotransmitters is released that is known collectively as "inflammatory soup” and it is responsible for producing pain. Nociceptive signals after reaching the spinal cord, will travel by espinotalamicos tracts to thalamus and other nuclei of the limbic system, where emotional responses will be involved and be modulated by a series of emotions, finally arriving to the somatosensory cortex, where they finally join as pain. Treatment of pain includes the NSAIDs COX1 and COX2. The latter proved to be approximately ten times safer at gastrointestinal level than the NSAID nonselective. Strong and weak opioids and NSAIDs are widely used in acute postoperative pain. Cancer pain is well founded. For neuropathic pain the neuromodulators such as some antidepressants and anticonvulsants, have proven to be very useful. It is estimated that 10% of patients with chronic pain are benefited by some kind of intervention.
Keywords : Basic pain management; acute and chronic pain; interventionism.