(1) Department of Anaesthesia, Royal Free Hospital, London, UK   19.1 Diclofenac It is the most commonly used NSAID. It has analgesic, antipyretic and anti-inflammatory activity. There is an increased…

(1) Department of Anaesthesia, Royal Free Hospital, London, UK   NSAIDs act through inhibition of cyclooxygenase enzyme (COX-1 and COX-2), thus inhibiting prostaglandin synthesis. Arachidonic acid is a polyunsaturated fatty…

(1) Department of Anaesthesia, Royal Free Hospital, London, UK   17.1 Morphine Morphine is a phenanthrene derivative. The effects are mediated by μ receptors. It is more effective for visceral…

(1) Department of Anaesthesia, Royal Free Hospital, London, UK   An opioid is a substance that shows affinity for opioid receptor. Though they are very effective in the management of…

(1) Department of Anaesthesia, Royal Free Hospital, London, UK   Serotonin is a transmitter found in the central nervous system. It is involved with nociception at the peripheral and spinal…

(1) Department of Anaesthesia, Royal Free Hospital, London, UK   Glutamate and GABA receptors are amino acid neurotransmitters present in the central nervous system. They are involved with nociception at…

(1) Department of Anaesthesia, Royal Free Hospital, London, UK   Action potential is initiated by voltage-gated sodium channels. Alterations in channel properties can contribute to inflammatory and neuropathic pain. Voltage-gated…

(1) Department of Anaesthesia, Royal Free Hospital, London, UK   K channels are present in all the cells and maintain resting membrane potentials. Closing of K channel leads to depolarisation….

(1) Department of Anaesthesia, Royal Free Hospital, London, UK   11.1 X-Rays It uses ionising radiation. The density of tissue is proportional to the degree to which the beam is…

(1) Department of Anaesthesia, Royal Free Hospital, London, UK   Life expectancy is increasing and people are living longer. At the same time, the incidence of persistent pain is increasing….