CHRONIC PAIN PATHOLOGY: WHY DOES MORE DILAUDID MAKE THINGS WORSE? │ EP132
Show notes
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Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.
Your fusion patient's pain gets worse every time you give more hydromorphone. Is she tolerant, or did the opioid make it worse? In Week 6 of our SEE/NCE series, we explain what changes in the nervous system when pain becomes chronic, so you can build a plan that actually works for your chronic pain patients.
In this episode:
- The four steps of pain (transduction, transmission, modulation and perception) and a memory trick to keep them straight
- Nociceptive vs neuropathic pain, plus allodynia vs hyperalgesia
- Peripheral and central sensitization, wind-up, and the magnesium "bouncer" at the NMDA receptor
- Chronic postsurgical pain, CRPS and the Budapest criteria, phantom limb pain, postherpetic neuralgia and fibromyalgia
- Opioid tolerance vs opioid-induced hyperalgesia, and what to do when more opioid makes the pain worse
- A perioperative plan and multimodal toolbox mapped to each step of the pain pathway
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- SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards
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Mentioned in this episode:
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