DEFINISI NYERI

Pengalaman sensorik dan emosional yang tidak menyenangkan akibat kerusakan jaringan, baik
aktual maupun potensial, atau yang digambarkan dalam bentuk kerusakan tersebut

Definisi Nyeri
Nyeri Fisiologik
Nyeri yang timbul akibat berbagai stimuli yang tidak menimbulkan kerusakan jaringan
Nyeri Nosiseptif / Nyeri inflamasi
Nyeri yang timbul akibat berbagai stimuli yang menimbulkan kerusakan jaringan
Nyeri Neuropatik
Nyeri yang didahului atau disebabkan oleh lesi atau disfungsi primer pada sistem saraf
Nyeri Psikogenik/Nyeri Fungsional
Nyeri di mana faktor psikogenik dominan, tanpa kerusakan jaringan dan sistem saraf sebagai
penyebab

Stimulus yg membangkitkan nyeri

Kulit injury jaringan ok tusukan, sayatan, panas dan dingin

Lambung/usus inflamasi mukosa, spasma otot polos, perlengketan
Otot-otot lurik iskemik
Otot skletal kontraksi terus menerus
Otot jantung iskemik
Sendi inflamasi, saline hipertonik
Arteri distensi, pulsasi berlebihan
Pereganagan arteri dan mening (sakit kepala)

The Process of Pain

The process of pain four phases :

1. Transduction
2. Transmission
3. Perception
4. Modulation

1. Transduction

Conversion of chemical information at cellular level electrical inpulses that move

toward the spinal cord
Begins when injured cells release chemicals such as prostaglandin, Substance P,
bradykinin, histamin, and glutamat excite nociceptor in the skin, bone, joints, muscles,
and internal organs

2. Transmission
The phase during wich stimuli move from the peripheral nervous system brain
Occurs when peripheral nociceptor form synapses with neurons within the spinal cord
that carry pain inpulses via fast and slow nerve fibers ( A delta and C fiber ).
With the help of substance P, pain impulses move higher level in the brain RAS,
thalamus, cerebral cortex and lim
when pain impulses reach the thalamus two responses occurs
First the thalamus transmits the message to the cortex, where the location and
severity of the injury are identified
Second it notifies the nociceptor that the message has been received and that
continued transmission is no longer necessary.

3. Perception

occurs when the pain threshold (point at wich sufficient pain transmitting stimuli reach the
brain) is reached.
Pain thresold tend to be the same among healthy people, but each person tolerates the sensation
of pain diffrently
Pain tolerance (amount of pain a person endures) is influence by genetics, behaviors
(culture,gender,age) and other biopsychosocially anxiety level, past pain experiences, and
emotional dispotition

4. Modulation

The last phase of pain impulse transmission during wich the brain interacts with the
spinal nerves in a donward fashion to subsequently alter the pain experience.
At this point, the release of pain-inhibiting neurochemicals reduces the painful sensation
( endogenous opioids, GABA).

Klasifikasi Nyeri Neuropatik

I. Berdasarkan intensitas nyeri
II. Berdasarkan penyebab
III. Berdasarkan lokasi
IV Berdasarkan mekanisme

1. Berdasarkan intensitas nyeri

Pengukuran menggunakan skala nyeri

1. Numeric Pain Intensity Scale (NPIS)
1 3 Nyeri ringan
4 6 Nyeri sedang
7 10 Nyeri berat
2. Visual Analog Scale
3. Faces Pain Rating Scale (untuk anak)

III. Berdasarkan lokasi

1. Nyeri neuropatik sentral
2. Nyeri neuropatik perifer