Perioperative Pain Management
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What are some different signs of pain?
- elevated HR and RR
- dilated pupils
- excess salivation
- guarding painful area
- licking area
- decreased response to owner
What do animals do when they are comfortable after surgery?
- cats use litterbox
What can dogs and cats do that we can confuse with happiness when they are really in pain?
- dogs: wag their tails
- cats: purr
What is the purpose of preemptive analgesia?
- blocking the pain pathway before the painful stimulus
- the noxious stimuli are still causing wind-up which may lead to exaggerated pain upon recovery
What does multimodal analgesia refer to?
use of analgesic drugs from multiple classes
Why do we combine drugs from different classes?
the doses of each individual drug can be lowered, reducing the adverse side effects of each
a drug that binds to a receptor and stimulates a response
pain response to a normally innocuous stimulus
absence of pain sensation
a drug that blocks a receptor and prevents the response
agent that reduces fever
Define brachial plexus.
network of nerves originating from the ventral branches of the last four cervical and the first thoracic spinal nerves; gives off principal nerves to shoulder and forelimbs
pertaining to the cheek pouch
Define central sensitization.
hyperexcitability of pain perception in the spinal cord; also referred to as wind-up
increased pain response caused by local inflammation
Define multimodal analgesia.
providing analgesics from different drug classes
nerve ending that responds to noxious stimuli
the class of narcotic analgesics that are derived from opium
Define preemptive analgesia.
providing analgesics before the painful stimulus
Define somatic analgesia.
absence of pain sensation int he skin and musculoskeletal system
under the tongue
Define visceral analgesia.
absence of pain sensation in the internal organs
What is another term for N-methyl-D-Aspartate (NMDA)?
What are the two receptors that opioids bind to?
u and k
What is the body's natural opiate?
Which opioids bind to the u receptors?
Which opioids bind to the k receptors?
What is the antagonist for opioids?
What is buprenorphine?
partial agonist for the u receptor
Butorphanol is a k agonist but it is also a what?
Which provides a better analgesia, u or k agonists?
Which lasts long for butorphanol, analgesia or sedative effects? Why can it be a problem?
- sedative effects
- its a problem because an animal could be calm from the sedative effects but could still be experiencing pain
Which NSAIDs are approved for dogs?
Which NSAID is approved for cats?
a one time injection of meloxicam
What should we do when an animal is administered an NSAID preoperatively?
be put on fluids during anesthesia and monitor blood pressure
What the local anesthetics we use?
What do local anesthetics do?
inhibits nocicpetors, preventing transmission of painful stimuli and spinal wind-up
What would you like to do?
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