Anaesthesia Fundamentals | Physiology | Pain - Peripheral and Central Mechanisms 1

Pain - Peripheral and Central Mechanisms 1
Session Overview
Description
This session works through the peripheral and central mechanisms of pain.

Learning Objectives
By the end of this session you will be able to:

• Compare and contrast physiological and clinical pain
• Describe the neurological pathways involved in the above
• Describe the descending modulation of pain pathways

It has been recognised for some considerable time that pain presents a puzzle to the physiologist. On the one hand it is a protective reflex, which allows us to avoid tissue damage, but on the other hand it can become a severe punishment where the pain outlives any useful physiological purpose. Ronald Melzack described this very well in his work ‘The Puzzle of Pain’, published in 1973:

Anyone who has suffered prolonged severe pain comes to regard it as an evil, punishing affliction. Yet everyone recognises the beneficial aspect of pain. It warns us that something biologically harmful is happening to our bodies [1].

This session examines the puzzle of pain, which can extend from a normal protective mechanism to become a severe punishment. This is important to anaesthetists as every patient they care for will have the possibility of experiencing severe short-term or long-term pain.