NYERI dan AURA

NYERI Apa sih nyeri itu?Pengalaman sensorik dan emosional yang tidak menyenangkan akibat kerusakanjaringan, baik aktual maupun potensial, atau yang digambarkan dalam bentuk kerusakan tersebut.

Nyeri adalah pengalaman sensorik dan emosional yang tidak menyenangkan akibat kerusakan jaringan,baik aktual maupun potensial, atau yang digambarkan dalam bentuk kerusakan tersebut.Dari definisi nyeri, tersurat selain pengalaman sensoris terdapat pula pengalaman emosional. Kedua hal tersebut perlu diperhatikan dalam penanganan.

2klasifikasiI.Nyeri fisiologik

Nyeri timbul oleh berbagai stimuli yg tidak menimbulkan kerusakan jaringan

II. Nyeri patologik

1. Nyeri nosiseptik Nyeri timbul oleh berbagai stimuli yg menimbulkan kerusakan jaringan (somatik, viseral, nyeri rujuk/referred pain)2. Nyeri neuropatik 3. Nyeri psikogenik

Nyeri akibat rangsangan (aktivitas abnormal) pada sistem saraf nyeri neuropatik.Nyeri akibat kerusakan jaringan tubuh akibat trauma atau penyakit seperti kulit, otot, tendon, sendi, organ dalam nyeri nociceptive.Nyeri akibat proses psikologik yang mendasarinya atau akibat pengaruh tekanan lingkungan nyeri psikologik.

Rangsangan nyeri dimulai dari reseptor nyeri (nociseptor) yang bereaksi terhadap rangsangan:

Mekanik pukulan, trauma, cubitan, dll.Termal tersiram air panas, es, hawa dingin.Kimiawi zat-zat iritan (asam, bahan-bahan kimia) ataupun yang berasal dari tubuh sendiri.

HEATCHEMICALPRESSUREBRAINPANASPEGELPERIHModifikasi Meliala, 20036The Pain PathwayPain PerceptionBrainDorsal RootGanglionDorsal HornNociceptorSpinal CordGottschalk A et al. Am Fam Physician. 2001;63:1979-84.Fields HL et al. Harrisons Principles of Internal Medicine. 1998:53-8. 7Activation of peripheral pain receptors, also called nociceptors, by noxious stimuli generates signals that travel to the dorsal horn of the spinal cord via the dorsal root ganglion. From the dorsal horn, the signals are carried along the ascending pain pathway or the spinothalamic tract to the thalamus and the cortex. Pain can be controlled by pain-inhibiting and pain-facilitating neurons. Descending signals originating in supraspinal centers can modulate activity in the dorsal horn by controlling spinal pain transmission.1,2

Gottschalk A, Smith DS. New concepts in acute pain therapy: preemptive analgesia. Am Fam Physician. 2001;63:1979-1984. Fields HL, Martin JB. Pain: pathophysiology and management. In: Fauci AS, Braunwald E, Isselbacher KF, et al, eds. Harrisons Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:53-58.

2:19793:552:19813:55HeatColdIntenseForceMechanicalHeatColdPainAutonomic ResponseWitdrawal Reflex

Nociceptor sensory neuronNOCICEPTIVE PAINNoxius Pheripheral StimuliSpinal cordBrain8The term of pain is An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or descrived in term of such damageNociceptive Pain commonly called Physiological PainThis type of pain show no tissue damage.Pain intensity positively correlated with the strength of the stimulus, in example: mild bump (benturan ringan)

Spontaneous PainPain Hypersensitivity

Peripheral Nerve DamageNEUROPATHIC PAINSpinal cord InjuryBrain9Neuropathic pain: There is damaged axon caused the accumulation of sodium channles in the injury site and aling the entire length of axons, which favouring the generation of ectopic electrical impulses and hyperexitability