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Pain Pathways and Anesthetic Action

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JCole View Drop Down
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Joined: 03 Oct 2007
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    Posted: 01 Sep 2009 at 9:18am
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Pain Pathways and Anesthetic Action

Anesthesia is distinct from analgesia. An analgesic, or pain-relieving drug such as aspirin, may relieve a headache, but a person who takes an aspirin still feels other physical sensations, such as pressure, heat, cold, and vibration. In contrast, anesthetic drugs block all physical sensations, though for medical purposes their ability to block pain is among their most important effects. Pain is a crucial warning system that tells us when our bodies are in danger, but without anesthesia, pain would make surgery and various other medical procedures much more difficult—or even impossible.

The sensation of pain results from communication between nerve cells in the brain, spinal cord, and elsewhere in the body (see Nervous System). The process begins when certain nerve cell endings, known as pain receptors or nociceptors, are stimulated. Pain receptors are located in the skin, joints, muscles, the linings of the body cavities, and elsewhere in the body. Nerve impulses travel from pain receptors along nerve fibers to the spinal cord and then to the brain. Pain impulses are relayed through a brain structure known as the thalamus and then to the cerebral cortex, the area of the brain that interprets messages and generates the conscious sensation of pain. At several points along their journey from pain receptor to cerebral cortex, pain impulses can be modified. For example, chemicals known as endorphins, the body’s natural painkillers, interact with nerve cells in the brain and spinal cord to dampen the sensation of pain.

The various drugs used in anesthesia work by several different mechanisms to block the transmission or perception of pain and other sensations. Some sleep-producing drugs used as part of general anesthesia are injected into a patient’s veins. These drugs are taken up by organs, muscles, and brain tissue and interfere with the complex and poorly understood biochemical mechanisms of consciousness. Anesthetic drugs that are inhaled dissolve in the blood and circulate to the brain. There they interact with brain cells, especially cells in the cerebral cortex that are involved in sensory perceptions. Opiates, a family of opium-derived pain relievers that includes morphine, codeine, and fentanyl, act like the body’s own natural endorphins to dampen the sensation of pain. Drugs used as local anesthetics block pain impulses in a specific part of the body, preventing these nerve impulses from reaching the brain. These drugs interfere with the chemicals inside nerve fibers that are involved in transmission of nerve impulses.

Contributed By:
Monica Winefryde Furlong, M.B., Ch.B., M.D.
Attending Anesthesiologist, Beth Israel Medical
Center North, New York, NY. Author of Going Under:
Preparing Yourself for Anesthesia.

"Anesthesia," Microsoft® Encarta® Online Encyclopedia 2009
http://encarta.msn.com © 1997-2009 Microsoft Corporation. All Rights Reserved.
© 1993-2009 Microsoft Corporation. All Rights Reserved.

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