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. 

This resource has been updated by our Pain Editor Dr Tauheed Shaikh. We have added some new articles written by the following Anaesthetists in the Oxford Deanery:

Dr Sarah Hudson
Dr Rebecca Medlock
Dr Emma Bryden
Dr Katharine Francis
Dr Manojit Sinha
Dr Aimee Manicom

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?