Visceral pain

Publication date: Available online 8 September 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Anu Kansal, John Hughes Pain is one of the commonest symptoms the patient presents with. Visceral organs were thought to be insensitive to pain in the past but now we know this not to be true. It is more common than somatic pain and originates from the internal organs in the thorax, abdomen or pelvis. These organs are innervated by parasympathetic (vagus and sacral parasympathetic fibres) and sympathetic (thoracolumbar sympathetic chain – T1–L2) nervous systems. The afferent and efferent fibres to the organs accompany the sympathetic nervous system. The sensory system to the gut is specialised and divided into enteric and extrinsic nervous system. The physiology of visceral pain is poorly understood compared to somatic pain but it is well established that peripheral and central sensitisation along with dysregulation of the descending pathway plays a significant role. Pain originating from visceral organs is usually diffuse, dull aching, poorly localised and can be associated with phenomenon such as, referred somatic pain, referred hyperalgesia, visceral hyperalgesia and viscero-visceral hyperalgesia. Treatment of visceral pain involves identifying and treating the cause, if identified and the management of pain. Patient education and information plays an important part in management along with pharmacological and non-pharmacological treatments.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research