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Nonpharmacological Pain-Relief George Ann Daniels MS, RN Nonpharmacolocial Interventions Cognitive-behavioral and physical approaches Goal Change patients perceptions of pain Alter pain behavior Provide patients with a greater sense of control

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nonpharmacological pain relief

Nonpharmacological Pain-Relief

George Ann Daniels MS, RN

nonpharmacolocial interventions
Nonpharmacolocial Interventions
  • Cognitive-behavioral and physical approaches
  • Goal
    • Change patients perceptions of pain
    • Alter pain behavior
    • Provide patients with a greater sense of control
criteria for nonpharmacological interventions
Criteria for Nonpharmacological Interventions
  • Find such interventions appealing
    • By in effect
  • Express anxiety or fear
  • May benefit from avoiding or reducing drug therapy
  • Are likely to experience or need to cope with a prolonged interval of postoperative pain
  • Have incomplete pain relief after use of pharmacological interventions
acupressure
Acupressure
  • Asian medicine
  • Opens congested energy pathways to promote a healthier state
  • Nurse therapist
    • Applies pressure along energy pathways
relaxation
Relaxation
  • Mental and physical freedom from tension and stress.
  • Provides individual self control when discomfort or pain occurs
    • Reversing the physical and emotional stress of pain
  • Effective at any phase of health or illness
  • Meditation, Zen, guided imagery and progressive relaxation exercise
slide6
Common sensations
    • Decrease in temperature or numbness of a body part
  • Environment
    • Free of noise and other irritating stimuli
    • Body positioning
    • Light sheet or blanket for warmth
      • Comfort
body positions for relaxation
Body Positions for Relaxation
  • Sitting
    • Sit with entire back resting against back of chair
    • Place feet flat on floor
    • Keep legs separated
    • Hand arms at the side or rest on chair arms
    • Keep head aligned with spine
  • Lying
    • Keep legs separated with toes pointed slightly outward
    • Rest arms at sides without touching sides of body
    • Keep head aligned with spine
    • Use thin, small pillow under head
effects of relaxation
Effects of Relaxation
  • Decreased pulse, blood pressure, and respirations
  • Decreased oxygen consumption
  • Decreased muscle tension
  • Decreased metabolic rate
  • Heightened global awareness
  • Lack of attention to environmental stimuli
  • No voluntary change of position
  • Sense of peace and well- being
  • Deep, awake, restful period of alertness
guided imagery
Guided Imagery
  • Creation of an image in the mind
    • Special place of comfort and/or rest
  • Concentration of the image
    • Less aware of pain more in tune with image
  • Nurse’s voice calm, soft voice, speaks continually
progressive relaxation
Progressive Relaxation
  • Relaxation of the entire body
  • 15 minutes
  • Tense areas are replaced with warmth and relaxation
  • Relax better with eyes closed
  • Soft music background
  • Combination of controlled breathing exercise and a series of contractions and relaxations of muscle groups
distraction
Distraction
  • The reticular activating system inhibits painful stimuli if the patient receives sufficient or excessive sensory input
  • Pleasurable stimuli cause the release of endorphins
  • Directs the patients attention to something else
    • Reducing the awareness of pain and increasing the tolerance of pain
  • Works best short term
    • Short intensive pain that lasts only for a few minutes
  • Singing, praying, describing photos or pictures aloud, listening to music, and playing games
music
Music
  • A form of distraction
  • Perform ( playing an instrument or singing) or listen to music
  • Music matches a person’s mood
  • Music with no vocals
  • Listen for at least 15 minutes
music to control pain
Music to Control Pain
  • Match musical selections to the patient’s taste.
    • Consider age and background
  • Use earphones to avoid annoying other patients or staff and help patient to concentrate on music
  • Be sure controls on the radio, CD, or tape player are easy to press, manipulate, and distinguish
  • Have family members bring tapes or CD’s from home
  • If pain is acure, increase the volume of the music. As pain decreases, reduce volume
slide14
If background music is provided, select general types suited to the patient’s preferences
  • Have the patient concentrate on the music and emphasize rhythm by tapping fingers or patting the thigh
  • Avoid interruptions by dimming lights and closing the drapes or door
  • Leave patients alone as they listen to the music
biofeedback
Biofeedback
  • Behavioral therapy
  • Gives the patient individual information about a physiological response
    • B/P, Tension
  • Ways to exhibit voluntary control over the responses
reducing pain perception
Reducing Pain Perception
  • Controlling painful stimuli
    • Tighten and smooth wrinkled bed linens
    • Position tubing on which patient is lying
      • Foley Bag
    • Loosen constricting bandages
      • Unless contraindicated
    • Change wet dressings and linens
    • Position patient in anatomical alignment
    • Check temperature of hot or cold applications, including bathwater
slide17
Lift patient in bed-do not pull
  • Position patient correctly on the bedpan
  • Avoid exposing skin or mucous membranes to irritants
    • Urine, stool, wound drainage
  • Prevent urinary retention by keeping Foley catheters patent and free flowing
  • Prevent constipation with fluids , diet, and exercise
cutaneous stimulation
Cutaneous Stimulation
  • Stimulation of the skin to relieve pain
  • Massage, warm bath, ice bag
  • Avoid cutaneous stimulation over sensitive skin
    • Burns, bruises, skin rashes, inflammation, and underlying bone fractures
cold and heat applications
Cold and Heat Applications
  • Relieve pain and promote healing
  • Application varies with problem
    • Heat may relieve pain from tension headaches
    • Cold may relieve pain from inflamed joints
  • Safety precaution
    • Check temperature
    • Avoid direct application
    • Caution in spinal cord injuries, confused patients, neuropathy
massage
Massage
  • Application of touch and movement to muscles, tendons and ligaments without manipulation of joints
  • Blocks perception of pain impulses
  • Relaxes muscle tension and spasm
  • Back rub
    • 3-5 minutes