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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. 

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

 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

The use of local anaesthetics in acute pain management
Opioid receptors
Drugs used to treat neuropathic pain
Patient-controlled analgesia (PCA)
Pain in patients with burns
Principles of analgesia for day surgery
Intrathecal opioids for acute pain
Epidural infusion and patient-controlled epidural analgesia (PCEA)
Assessment and management of pain from rib fractures
Non-steroidal anti-inflammatory drugs (NSAIDs)
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)
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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