Signal to Cortex
The cell bodies of primary nociceptor neurons are housed in this spinal structure
What is the dorsal root ganglion?
Reflex sympathetic activation from acute nociception increases this parameter, elevating myocardial oxygen demand
What is tachycardia?
This endogenous opioid peptide preferentially activates the kappa receptor class, modulating pain and dysphoria
What is dynorphin?
These lipid-soluble weak acids bind extensively to albumin, so hypoalbuminemia raises their free fraction and risk of toxicity.
What are NSAIDs?
This peripherally acting μ-opioid receptor antagonist accelerates postoperative gastrointestinal recovery by blocking opioid effects in the gut without affecting central analgesia.
What is alvimopan (entreg)?
The slow conduction velocity of nociceptive axons is due to these two structural features compared with other somatic sensory fibers
What are small diameter and lack of (or thin) myelination?
What is the MOA of Hypertension related to pain?
What is α-Adrenergic vasoconstriction
As a partial μ-receptor agonist, this drug’s high affinity can precipitate withdrawal if given to a patient on full agonists.
What is buprenorphine?
Hepatotoxicity risk limits this centrally acting analgesic and what is it's maximum dose?
What is acetaminophen and 4g daily?
This synthetic opioid is ten times more potent than morphine, has an onset four times faster than fentanyl, but only a third of its duration, making it ideal for rapid intraoperative titration.
What is alfentanil?
Nociceptive afferents ascend from the spinal cord to the thalamus via this anterolateral sensory pathway
What is the spinothalamic tract?
Exquisite pain on passive stretch of a muscle compartment should raise concern for this limb-threatening emergency.
What is compartment syndrome?
n renal failure, this opioid is preferred because it lacks active metabolites that accumulate and cause respiratory depression.
What is fentanyl?
This mechanism underlies ketamine’s subanesthetic opioid-sparing effect via modulation of the glutamatergic system.
What is NMDA receptor antagonism?
Metabolized by nonspecific plasma esterases and boasting a context-sensitive half-life under five minutes, this opioid allows swift on/off control during total intravenous anesthesia.
What is remifentanil?
After first-order nociceptive neurons synapse in the dorsal horn, the second-order fibers cross midline through this commissure before ascending in the spinothalamic tract.
What is the anterior white commissure?
Severe, new-onset back pain in a patient with an epidural infusion warrants evaluation for this compressive complication
What is an epidural hematoma?
Compared with fentanyl, this neuraxial opioid’s hydrophilicity yields greater CSF spread and a longer duration of action.
What is morphine?
The analgesia from a 5% lidocaine patch comes from blocking these channels on peripheral nociceptors.
What are voltage-gated sodium channels?
Combining μ-receptor agonism, NMDA antagonism, and monoamine reuptake inhibition, this long-acting opioid is used for both chronic pain and intraoperative analgesia.
What is methadone?
In the trigeminal system, the cranial equivalent of the dorsal root ganglion that houses nociceptor cell bodies for head and face pain
What is the trigeminal ganglion?
Explain bradycardia related to pain
What is the intense visceral nociception can paradoxically trigger this vagally mediated reflex resulting in low heart rate?
This active metabolite of morphine, formed via hepatic glucuronidation and renally excreted, accumulates in renal failure to prolong analgesia and heighten toxicity.
What is morphine-6-glucuronide?
Dexmedetomidine produces sedation and analgesia without respiratory depression through agonism of this receptor subtype.
What is the alpha-2 adrenergic receptor?
This mixed‐action opioid agonist–antagonist is often used to relieve neuraxial opioid–induced pruritus without reversing analgesia.
What is nalbuphine?