Pain control, adverse effects and degree of satisfaction of postsurgical patients in the acute pain unit in a Mexican hospital using an electronic platform as a tool for assessment

Abstract

The pathophysiology is the result of the harmful stimulation of the skin, the subcutaneous tissues, the viscera and the neuronal structures, so this is a form of exceptional acute pain. The pain occurs because inflammatory and sensitizing mediators are released that include cytokines, bradykinin and prostaglandins from injured and inflammatory cells at the site of tissue damage. Nociceptors demonstrate reversible plasticity in response to inflammatory mediators. The activation threshold of nociceptors decreases, which results in greater sensitivity to pain at the site of tissue injury. The release of ATP by the injured cells plays an important role in allodynia and the spontaneous activity by incision in the primary afferent fibers provides a maintenance of the neurons of wide dynamic range in the posterior horn in a sensitized state, as well as the repetitive stimulation of primary afferents Type C fibers that promote an exaggerated response to painful stimuli.11 The NMDA receptor acts through the large influx of calcium ions (Ca2þ) that occurs when the channel is activated. Once inside the cell, Ca2þ can activate several effectors and promote later changes. That can promote plasticity mechanisms such as long-term potentiation.