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Acute pain

The Primary ( ) and Final () FRCA examinations require an extensive knowledge of pain management. We have therefore written a new educational resource section on this topic. The tutorials have been tailored to the FRCA syllabus and we have also added some past questions relevant to these topics.

Read other sections by using the navigation bar on the right side of every page. 

 Primary FRCA Syllabus

Physiology and Biochemistry

Pain: afferent nociceptive pathways, dorsal horn, peripheral and central mechanisms, neuromodulatory systems, supraspinal mechanisms, visceral pain, neuropathic pain… influence of therapy on nociceptive mechanisms…

Regional anaesthesia

 Indications, technique and management of the complications of spinal and epidural (including caudal approach) analgesia…

Q. Primary Viva Question

Give a detailed description of the pain pathway that becomes activated if you prick your finger with a pin. What happens in the thalamus and cerebral cortex? Describe the neurotransmitters involved.


 Final FRCA Syllabus

Pain management

 A detailed knowledge of the control of acute pain in the context of postoperative and post-traumatic conditions will be expected, as will an understanding of the principles of chronic pain management in the pain clinic setting. Anatomy, physiology, pharmacology and basic psychology relevant to pain management. Assessment and measurement of acute pain - including special problems with children, the elderly, and patients who are unconscious or in intensive care….use of medication for pain management; conventional analgesics and adjuvant analgesics; side effects; problems of drug dependency and addiction

The role of and indications for neural blockade:
peripheral nerve, plexus, epidural and subarachnoid blocks, techniques of sympathetic blockade,neurolytic agents and procedures, implanted catheters and pumps for drug delivery
Stimulation produced analgesia including transcutaneous techniques and acupuncture Other treatment modalities; physical therapy, surgery, psychological approaches, rehabilitation approaches, pain management programmes..the organisation of pain management services…

Q. Short Answer Question

SAQ November 1996: What are the advantages and disadvantages of intravenous patient controlled analgesia for post-operative pain control?  

SAQ May 2001: How would you provide optimal pain relief for a 60 year old man undergoing shoulder replacement?

Articles on acute pain

Definition of pain
Assessment of pain
Pain fibres
The spinal cord
Pain pathways
Physiology of pain
Pain modulation
Pharmacology of pain
Opioid analgesics
Opioid agonists and partial agonists
Non-opioid analgesics
Intravenous paracetamol
Other approaches
Patient controlled analgesia (PCA)
Spinal anaesthesia
Spinal anaesthesia: Choice of needle
Spinal anaesthesia: Choice of local anaesthetic
Epidural anaesthesia
Patient controlled epidural analgesia (PCEA)
Caudal anaesthesia
Combined spinal and epidural Anaesthesia (CSE)
Acute pain-analgesics
Effectiveness of acute postoperative pain management
Acute and postoperative pain in children
Royal College of Anaesthetists guidelines on Pain Management
Guidelines in pain management

is endorsed by The British Pain Society for its role in education. Their site may be viewed by clicking on the icon.


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