Pain Management: The New Legal Trojan Horse

Pain is a subjective symptom and varies with each individual patient. Pain can be either acute or chronic. Acute pain (nociceptive) is usually associated with an area of injury [49]. It arises from a stimulus outside the nervous system and is associated with increased autonomic activity. The pain is primarily limited to the injured area. When the injured tissue heals, the pain resolves. Acute pain serves a protective function for the body. The most common class of nonnarcotic medication used to treat acute pain is nonsteroidal antiinflammatory drugs (NSAIDs). They are divided into two categories: nonselective NSAIDs and selective NSAIDs. Nonselective NSAIDs block both enzymes cyclooxygenase 1 and cyclooxygenase 2. They are most effective for treating mild and moderate pain; their most serious complications include gastrointestinal bleeding and cardiac thromboembolic episodes. On the other hand, selective NSAIDs block only the cyclooxygenase 2 enzyme. The selective NSAIDs provide very good pain relief for mild, moderate, and severe pain. Their most serious complications are cardiovascular [50].


Chronic Pain Pain Management Acute Pain Continue Medical Education Nonselective NSAID 
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© Springer Science+Business Media, LLC 2008

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