Pain Management & Inflammation

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Author:
anniles
ID:
165953
Filename:
Pain Management & Inflammation
Updated:
2012-08-29 21:21:22
Tags:
Inflammation analgesia anti inflammatory drugs pain
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Description:
Intro to pain management
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  1. Define pain.
    Unpleasant sensory or emotional experience associated w/ a protective motor action & learned avoidance
  2. What are important factors that the technician must learn in relation to pain?
    • Recognizing procedures which will stimulate pain
    • Use of techniques which minimize pain
    • Monitor behavior & physiological parameters that indicate pain
    • Bringing animal's pain to the attention of the doctor
  3. Pain can increase ______, ______ and _____
    Stress; HR; BP
  4. An increase in stress is known to cause what effects on the body?
    • Increased cortisol levels which can decrease wound healing & supress the immune system
    • Increase metabolic rates
    • Anorexia
  5. Special nerve cells which detect noxious stimuli are called?
    Nociceptors
  6. What are examples of noxious stimuli that nociceptors detect?
    • Distension/stretching
    • Mechanical injury
    • Chemicals released by inflammation or tissue damage, such as leukotrienes, histamines, and prostaglandins
  7. What are the steps of pain? Briefly describe them.
    • Transduction: stimulus transformed to electric signals in nerves
    • Transmission: signal moves alon peripheral nerves to spinal cord
    • Modulation: nerve impulse is amplified or suppressed
    • Perception: impulses go to brain to recognize pain
  8. What is it called when pain is intercepted at multiple pathways?
    Multimodal therapy
  9. What are the 2 types of sensory neurons?
    A delta fibers & C fibers
  10. The sensory neuron that is also referred to as "first pain" and localizes pain to an exact site.
    A delta fibers
  11. What type of pain signals are transmitted by A delta fibers?
    Sharp, descrete pain
  12. What type of pain signals are transmitted by C fibers?
    Dull, aching or throbbing sensations
  13. A delta fibers have long __________ neurons, while C fibers have short _________ neurons.
    Myelinated; unmyelinated
  14. What are the 2 types of pain?
    • Somatic pain
    • Visceral pain
  15. Somatic pain is transmitted by what sensory neuron(s)?  Visceral pain?  What type of pain is associated with each?
    • A delta & C fibers; stabbing, throbbing, or aching
    • C fibers; cramping, burning
  16. What is the wind-up phenomenon?
    A secondary reaction to chronic or intense pain where nerve response to painful stimulation is increased, resulting in non-responsive or chronic pain
  17. When nerve fibers require less stimulation to initiate pain, this is called?
    Hyperalgesia
  18. When nerve fibers that do not typically carry pain sensation are recruited, it is called?
    Allodynia
  19. Why is pre-emptive pain control so important?
    Prevention of wind-up
  20. What are the 4 levels of pain?  Name examples of procedures or complications in each level.
    • Mild: lacerations, dental w/ no extractions, insect sting
    • Moderate: OHE, castration, dental w/ extractions, laparotomy, cystotomy, gastrotomy, mass removal
    • Severe: fracture repair, joint sx, mammary gland sx, enucleation, ear sx
    • Excruciating: neuropathic pain, multiple fractures, bone cancer
  21. Oseosarcoma is common in the long bones of what dogs?
    Lg & giant breeds
  22. When a mass is removed from an animal, it is usually sent  in for a histopathology to detect what?
    Clean margins
  23. Chronic cases of otitis externa may require what procedure?
    Total ear canal ablation
  24. What is acute pain?
    Sudden onset of pain that can commonly be treated with analgesics
  25. What is chronic pain?
    Long standing pain that may be unresponsive to drug therapy
  26. What is referred pain?
    Pain that is felt in a part of the body other than the effected area, such as in IVDD
  27. An increase in sensitivity to stimuli like sound or touch is called?
    Hyperesthesia
  28. This classification of pain is poorly responsive to pain meds and is due to the damage of a peripheral nerve or the spinal cord.
    Neuropathic pain
  29. What is the position commonly seen in animals with abd pain?
    Prayer position
  30. Amounts of analgesia needed to make a patient comfortable varies between what?
    • Species
    • Age
    • Breed
    • Level of consciousness
  31. Patients should closely be monitored for signs of pain for how long post-op?
    1st 24 hrs
  32. What can make it difficult to assess a patients level of pain?
    • Unknowing of normal behavior
    • Subtle changes in behavior
    • Sedation modifies behavior
  33. What are common signs of pain?
    • Vocalization
    • Gaurding or self mutilization
    • Attitude changes
    • Appetite decrease
    • Crying, hiding, aggression w/ palpation
    • Physiologic signs
  34. True or False: poor and positive responses to pain should be reported to the veterinarian.
    True
  35. How often should patients be monitored for pain?
    Anywhere from every 30 min to every 6 hrs depending on  the procedure
  36. What is dysphoria?
    Abnormal vocalization or behavior typically due to opioids or anesthesia
  37. What is emergence delirium?
    Abnormal behaviors during anesthetic recovery
  38. How can a VT help alleviate discomfort?
    • Decrease fear and anxiety
    • Keep patient clean & dry
    • Provide many opportunities to urinate and defecate
    • Comfortable bedding and quiet surroundings
    • Turn animals unable to move itself every 2 - 4 hours
    • Cool bath to soothe skin conditions
    • Soothing salves for burns upon vet orders
    • TLC
  39. What are routes of administration for opioids?
    • IV/SQ/IM
    • Intra-articular
    • Epidural
    • Transdermal
  40. What are Fentanyl patches used for in the cat and dog?
    • Post-op pain control
    • Chronic, severe pain due to cancer
  41. Alternate analgesia should be used during use of Fentanyl patches for how long in the cat and dog?
    • 6 - 12 hours in cats
    • 12 - 24 hours in dogs

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