Assessment and Management of Pain

Morphine is one of the prevalent analgesic opioid that is considered as potent and effective pain relievers and has been undertaken for past many years. This is used for undertaking both acute and chronic pain management. Morphine targets the pain due to myocardial infarction, surgery, injuries and others (Macintyre and Schug 2014). Morphine is an opiate drug that targets opioid receptors leading to the formation of the analgesia with the help of the mechanism of hyperpolarisation of interneuron and decrement in the release of the transmitters of pain. Human body consist of inbuilt analgesic and pain relieving system that regulates in the body by minimizing the sensations in the spinal cord that further transmits the sensations of the pain to different locations with the help of synapse within the neurons. Activation of the pain management in the spinal cord occurs by the supraspinal mechanism. This mechanism includes opioid system that is responsible for the release of endorphins, the adrenergic system that is responsible for the release of norepinephrine and serotogenic system that is responsible for the release of serotonin. Synergy and communication among all leads to the activation of analgesic activity. When the inbuilt analgesic system fails to control pain, additional analgesic drugs such as morphine is used to increase the working capacity of this inbuilt system. Besides this, morphine also regulates the generation of supraspinal structures leading to the activation of the whole system. Adrenergic drugs react with specific receptors for the production of the analgesia and morphine further reacts with these drugs for the regulation of the analgesia (Stang et al. 2014). Visceral pain targets the thoracic, abdominal and pelvic organs of the body and it is considered to be one of the most common types of the pain a doctor responds to. Visceral pain targets chest, prostate gland, pelvis, gastrointestinal tract, gall bladder, scrotum and vulva (Mayer et al. 2015). Surgical treatments available for the treatment of Angina pectoris and other chest pain is coronary artery bypass surgery or grafting and percutaneous coronary intervention that undertakes the change in the oxygen concentration in the body with the help of certain channel blockers such as nitrates and calcium. Alteration in the oxygen demand and supply leads to the reduction of the pain. Besides this, Cordotomy is another surgical procedure that is used for the treatment of visceral pain due to terminal maladies or illness such as cancer, AIDS, pulmonary fibrosis and many others. This surgery is undertaken percutaneously with the help of fluoroscopic or computerized tomography scan. The laminectomy surgery is undertaken in the spinothalamic tract under the presence of anaesthesia. Another technique that is appropriate as the surgical treatment for the visceral pain is myelotomy which are of two types Commissural and Punctuate or limited Midline. Commissural Myelotomy undertakes the m ultiscale laminectomy in the spinal cord. This targets the nerve fibre joining the brain with spinal cord and interrupts the pain there. While Punctuate or Limited Midline is a neuroablative surgery that undertakes the treatment of bladder, pancreas and colon by interrupting the center of dorsal column. This is one of the most effective methods as it can be used for the treatment of posterior columns of the organs (Lazzeri et al. 2015). Lazzeri, L., Vannuccini, S., Orlandini, C., Luisi, S., Zupi, E., Nappi, R.E. and Petraglia, F., 2015. Surgical treatment affects perceived stress differently in women with endometriosis: correlation with severity of pain.  Fertility and sterility,  103(2), pp.433-438. Macintyre, P.E. and Schug, S.A., 2014.  Acute pain management: a practical guide. CRC Press. Mayer, E.A., Gupta, A., Kilpatrick, L.A. and Hong, J.Y., 2015. Imaging brain mechanisms in chronic visceral pain.  Pain,  156(0 1), p.S50. Stang, A.S., Hartling, L., Fera, C., Johnson, D. and Ali, S., 2014. Quality indicators for the assessment and management of pain in the emergency department: a systematic review.  Pain Research and Management,  19(6), pp.e179-e190.