3 keys to switching it off
The complex process of pain plays out on 3 levels.
"There is no way you can be feeling anything after what I just injected!"
Sometimes we judge our patients' reactions to be out of proportion, we show irritation, we negotiate with their pain, or we deny it outright. All of these clinician reactions feed fear, pain and loss of trust. What follows is sometimes avoidance of care, or other damaging consequences.
That is to forget that the brain's response is always subjective.
To control intraoperative pain, we cannot simply inject, inject again, and then add more if that is not enough. We first have to remember that the pain process is complex. It is not only local, it plays out in three stages:
1️⃣ Peripheral nociception, with its specific receptors
2️⃣ Transmission, along the ascending pathways, to the central nervous system, which analyzes the signal
3️⃣ The response sent back to the site of the original stimulus, which we can think of as the siren of the body's physiological alarm system.
How do we switch off the pain alarm system?
✅ Treat by choosing the right clinical procedure, at the right moment, with the right command of the gesture.
To limit nociception.
✅ Deliver a painless anesthetic technique that works the first time.
To cut the signal coming from the nociceptors, and so act on the ascending pain pathways.
✅ Take care of the person.
By combining technical skill with the way we are with people, which strengthens the patient's trust and acts on the descending pain pathways.
See also the videos:
- The brain controls the intensity of the response — https://www.youtube.com/shorts/NvfyhnbfQJI
- Pain control — https://www.youtube.com/shorts/cYaBKMnso9o
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