Ag 422 Pain Management
Terms
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- If there is no pain present what activities will a dog do?
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Eat
Shake
Yawn - If there is no pain present what activities will a cat do?
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Eat
Stretch
Sleep Curled Up
Yawn - Unpleasant sensory or emotional experience associated with actual or potential tissue damage.
- Pain
- Absence of pain in the presence of stimuli that would normally be painful.
- Analgesia
- Absence of all sensory modalities; the inability to perceive painful stimuli.
- Anesthesia
- What is hyperesthesia?
- increased sensitivity to stimulation
- What is multimodal or balanced anesthesia?
- use of 2 or more analgesic agents that differ in their mechanism of action to achieve more effective analgesia
- The reception, conduction and CNS processing of nerve signals generated by the stimulation of nociceptors.
- Nociception
- Naked afferent nerve ending preferentially sensitive to a noxious stimulus or a stimulus that would become noxious if prolonged.
- Nociceptor
- What is referred pain?
- pain felt in a body part other than that in which it originates
- Pain from skin, SQ, muscles, bones and joints characterized as stabbing, throbbing or aching is?
- Somatic pain
- Pain from internal organs characterized as cramping, burning, and gnawing is?
- Visceral pain
- What is windup?
- The buildup of chemical mediators during surgery that the animal becomes aware of post-op
- What is pre-emptive analgesia?
- establishing analgesia BEFORE the onset of pain
- How do you prevent windup?
- pre-emptive analgesia
- What are some cardiovascular signs of pain and/or distress?
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>Increased HR and BP
>pale MM
>Increased CRT
>Cool extremities - What are some respiratory signs of pain and/or distress?
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>rapid, shallow breaths, panting
>Decreased tidal volume - What are some Digestive signs of pain and/or distress?
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>Wt loss
>vomiting
>inappetance
>constipation
>diarrhea
>salivation - What are some musculoskeletal signs of pain and/or distress?
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>unsteady gait
>lameness
>weakness
>tremors
>shivering - What are some urinary signs of pain and/or distress?
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>reluctance to urinate
>loss of house training - What are some laboratory signs of pain and/or distress?
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>increased WBC
>increased lymph
>increased glucose
>increase PCV
>increased cortisol
>increased catecholamines - What are the 3 methods of pain control?
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1. Endorphins
2. Non-pharmacological
3. Pharmacological - What are some non-pharmacological ways of pain control?
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>massage therapy
>cold/hot therapy
>physical therapy
>non-traditional - magnetic, homeopathic,herbal, acupuncture - Morphine is used for both a _______ & _______?
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analgesic
preanesthetic - Morphine is used to treat what type of pain?
- visceral and somatic
- What is the perferred route of administration of morphine in cats?
-
SQ
**prevents vomiting and dysphoria - What is the duration of morphine?
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3-4 hours
time released oral - 12hrs - What are some side effects of morphine?
-
>GI (vomiting, salivation, defecation) - pretreat w/ ace
>histamine release w/rapid IV
>bradycardia (pretreat w/atropine)
>severe respiratory depression - Meperedine (demerol) effect is ______ and lasts only about _______.
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weak
1 hour - What is the preferable route of administration of meperedine? Why?
-
SQ
**IM is painful
**IV-hypotension & histamine release - What is the duration of action of oxymorphone?
- 4-6 hours
- Which opioid doesn't stimulate vomiting and histamine release?
- oxymorphone
- What are some side effects of oxymorphone?
-
>respiratory depression
>paradoxically causes panting
>bradycardia - Which opioid doesn't cause excitement in cats?
- hydromorphone
- What is the duration of action of Fentanyl?
- 30 minutes
- What is the duration of action using the transdermal fentanyl patch?
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4-12 hours in cat
12-24 hours in dogs - What are the side effects of the fentanyl patch in cats?
-
>dysphoria
>disorientation
>dilated pupils - What are the side effects of the fentanyl patch in dogs?
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>ataxia
>sedation - Butorphanol is used for what type of pain?
- better for visceral than for somatic pain
- What are the side effects of butorphanol?
- respiratory depression (ceiling effect)
- What is the duration of action of buprenorphine (buprenex)?
- Up to 12 hours
- What are the side effects of buprenorphine?
- respiratory depression (delayed onset)
- What type of pain is buprenorphine useful for?
- mild to moderate pain
- What is the number one side effect of NSAIDs?
- GI ulceration