a.

Definition
Pain is an unpleasant feeling such conditions are highly subjective because
of the feeling of pain is different for each person in terms of scale or
tingatannya, and the only person who can explain tersebutlah or evaluate the
pain they experienced (Aziz Alimul, 2006). Pain is defined as a condition that
affects a person and its extensions known if someone ever experienced
(Tamsuri, 2007).
Pain is a sensory experience as well as the unpleasant emotions and
improve tissue damage due to actual or potential. (Judith M. Wilkinson 2002).
An unpleasant sensory and emotional experience that arises in actual or
potential tissue damage or describe the damage. Sudden attacks or slowly in
intensity from mild to severe that can be anticipated with a predictable end and
with a duration of less than 6 months (the International Association of Pain
Studies).
b. physiology of Pain
The emergence of pain is closely related to the receptor and the
stimulation. Pain receptors in the mean is niciceptor, the nerve endings so free
that have little or no myelin spread on the skin and mucosa, especially in the
viscera, joints, the walls of the arteries, liver, and gallbladder.
Pain receptors can leave a response as a result of stimulation or
stimulation. The stimulation can change chemical substances such as
histamine, bradykinin, prostaglandins, and various acids that off if there is
damage to the tissue due to lack of oxygenation. Stimulation of the other can
be either thermal, electrical or mechanical.
c. Clasifikation of pain
Classification of pain are generally divided into two, namely acute and
chronic pain. Acute pain is pain that arises suddenly and quickly disappeared,
not exceeding six months and a marked increase in muscle tension.
Chronic pain is pain that arises slowly, usually lasts long enough, ie more
than 6 months. Included in the category of terminal chronic pain is pain,
chronic pain syndrome, and psychosomatic pain. Judging from the nature of
the occurrence, the pain can be divided into several categories, including
burning pain
d. stimulus of pain

A person can tolerate, withstand pain (pain tolerance) or recognize the

amount of pain before the pain stimulus (pain tolerance). There are several
types of pain stimulus, among them:
Trauma to the body tissues, such as surgery due to tissue damage from
direct irritation to the receptor. Disturbances in body tissues, for example in
edema due to an emphasis on pain receptors. Tumors, can also suppress the
pain receptors. Tissue ischemia, such as occurs in the blockade on coronary
arceria which stimulates pain receptors due to lactic acid heap.
e. Theory of Pain
There are several theories about the occurrence of painful stimuli,
including (Barbara C.Long, 1989):
1) Theory of Separation (specificity Theory). According to this theory, pain
stimuli enter the spinal cord (spinal cord) through Karnu synapse in the
dorsal posterior area, then up to the tractus lissur and crossed the median
line to the other, and end up in the sensory cortex where the pain stimulus
was passed.
2) Theory Patterns (Pattern Theory). Pain stimuli enter through the dorsal
root ganglion and spinal cord to stimulate the activity of T cells This
resulted in a response that merangsan to the higher part, the cerebral
cortex, as well as response and contractions cause muscles to contract,
causing pain. Perception is influenced by the modalities of the response of
T cell reaction
3) Gate Control Theory. According to this theory, the pain depends on the
work of large and small nerve fibers which are both located in the root
ganglion doralis. Stimulation of the large fiber will leave subtansia activity
resulting gelatinous lid door mechanism that inhibited the activity of T
cells and causes conductivity participate stimulation inhibited. Stimulation
of large fiber can directly stimulate the cerebral cortex. The result of this
perception will be returned into the spinal cord through efferent fibers and
reaksinta affect T cell activity in the stimulation of small fibers would
inhibit the activity of gelatinous substance and opened the door
mechanism, thus stimulating the activity of T cells which in turn will
deliver painful stimuli.
4) The theory of transmission and inhibition. Their stimulus on nociceptor
through implus nerve-impulse transmission, so implus pain becomes

effective by specific neurotransmitter. Then, inhibition implus pain

becomes effective by implus-implus on large fibers that block implusimplus the slow fibers and endogenous opiate system suppressive.
f. Factors Affecting Pain
Experience pain on a person can be affected by several things, among which
are:
1) Meaning of Pain. Pain for someone to have a lot of differences and most of
the sense of pain is a negative sense, as harmful, destructive, and others.
This situation influenced the environment and experience.
2) Persepsi perception of pain is highly subjective assessment of his place on
the cortex (the cognitive evaluation function). This perception is
influenced by factors that can trigger nociceptor stimulation.
3) Pain tolerance. This tolerance is closely related to the intensity of pain that
can affect a person's ability to withstand pain. Factors that may affect the
increased tolerance of pain include alcohol, drugs, hypnosis, movement or
run movement, diversions, strong faith and so on. While the factors that
reduce tolerance include fatigue, anger, boredom, anxiety, pain that does
not go missing, pain, and others.
4) The reaction to the pain. The reaction to the pain is the shape of a person's
response to pain, such as fear, anxiety, worry, cry and scream. All of this is
a form of response to pain that can be influenced by several factors, are
like the sense of pain, pain perspepsi level, past experiences, cultural
values, social expectations, physical and mental health, fear, anxiety, age,
and others.
g.

How to Measure Pain Intensity

Pain scale according to Hayward
Scale
0
1-3
4-6
7-9

Description
No Pain
Mild Pain
Moderate Pain
Very Painful, but it can still be controlled with the usual

10

activities
Very Pain and not bias controlled

Pain scale according to McGill

Scale
1
2
3
4
5

Description
No Pain
Pain is Being
Severe Pain
The Pain is very severe
Severe Pain