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Surgery > Analgesia > Flashcards

Analgesia Flashcards

1
Q

What is preemptive analgesia?

A

Treating pain before it occurs

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2
Q

What is important to understand before administering preemptive analgesia?

A
  • Pain pathways

- Mechanisms of actions of analgesic therapies

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3
Q

Define analgesia

A

The absence of sensibility to pain

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4
Q

What is an analgesic?

A

Any method or drug that relieves pain

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5
Q

Define deep pain

A

Pain originating in tendons, joints, muscles, and periosteum.

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6
Q

Define distress

A

A state in which the animal is unable to adapt to an altered environment or altered stimuli.

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7
Q

Define neuralgia

A

Pain exhibiting periodic intensification which extends along the course of one or more nerves.

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8
Q

What is pain?

A

Perception of an unpleasant sensory or emotional experience that results from potential or actual tissue damage.

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9
Q

Define stoic.

A

Indifferent to pain or pleasure.

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10
Q

What are 6 signs of inferred pain?

A
  1. Limp or gait altered
  2. Withdrawal of an injured part
  3. Awkward, abnormal postures
  4. Worried or distressed expression
  5. Looking at, licking, scratching, or kicking at the site of perceived pain
  6. Vocalizing
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11
Q

What are 3 peripheral pain receptors?

A
  1. Mechanosensitive
  2. Thermosensitive
  3. Chemosensitive
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12
Q

Describe the pathway of nerve impulses.

A

Sensory neuron in peripheral tissue –>
Spinal cord neuron –>
Neuron in brain that conveys conscious sensation of pain

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13
Q

What are two terms that define an increase in activity of spinal neurons.

A
  • Spinal facilitation

- Wind-up

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14
Q

What occurs with wind up pain?

A

A prolonged period of hyperalgesia.

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15
Q

Wind up pain in noted especially in ____ after _______ procedures.

A

Cats; onychectomy

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16
Q

______ are released from CNS neurons when the body is traumatized or under stress.

A

Endorphins.

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17
Q

What are 4 things that will stimulate the release of endorphins?

A
  • Acupuncture
  • Transcutaneous electric nerve stim. (TENS)
  • Massage
  • Cold or heat application
18
Q

What are the different methods of pain control?

A
  • Remove primary cause if possible
  • Nursing care
  • Analgesic drugs
19
Q

What type(s) of drugs can be used for preemptive analgesia?

A
  • Preanesthetic Drugs
  • Epidural Anesthesia
  • Local Anesthetics
  • NSAIDs (under certain conditions)
20
Q

What type of drug can be used to relieve pain at the tissue level?

A

NSAIDs

21
Q

How do NSAIDs control pain at the tissue level?

A

They block the production of prostaglandins, etc.

22
Q

What type of drug can be used to relieve pain at the peripheral/spinal level? How do they relieve this pain?

A

Local anesthetics; They block transmission.

23
Q

What type of drug can be used to relieve pain at the CNS level?

A

Opioids and alpha-2 agonists as well as some NSAIDs.

24
Q

How do opioids relieve pain?

A

By blocking the perception of pain.

25
Q

Where do opioids act as pain receptors?

A

In the brain and spinal cord.

26
Q

Opioids can be used preemptively to achieve what effect?

A

To diminish wind up pain.

27
Q

Opioids can be used as a part of __________ technique to offer analgesia ___________ and into ___________ period.

A

Neuroleptanalgesia; intra-operatively; post-operatively.

28
Q

List 4 specific opioids used for moderate-severe pain?

A
  • Morphine
  • Oxymorphone (Numorphan)
  • Hydromorphone (Dilaudid)
  • Fentanyl (Duragesic, Sublimaze)
29
Q

List 3 specific opioids used for mild-moderate pain?

A
  • Meperidine (Demerol)
  • Butorphanol (Torbugesic, Torbutrol)
  • Buprenorphine (Buprenex)
30
Q

NSAIDs inhibit _________ synthesis.

A

Prostaglandin

31
Q

What are the two types of cyclooxygenase?

A
  • Cox-1

- Cox-2

32
Q

All NSAIDs are effective for ________ pain.

A

Somatic.

33
Q

Some NSAIDs are effective for ______ pain for __ to __ minutes after administration.

A

Visceral; 30 to 60 minutes.

34
Q

Most NSAIDs also have ____________ and _________ effects.

A

Antiinflammatory; antipyretic

35
Q

What are 9 NSAIDs that can be used?

A
  1. Aspirin
  2. Acetaminophen
  3. Ibuprofen
  4. Flunixin
  5. Ketoprofen
  6. Ketorolac (Toradol)
  7. Carprofen (Rimadyl)
  8. Meloxicam (Metacam, Mobic)
  9. Etodolac (EtoGesic)
36
Q

What are two NSAIDs used for preemptive analgesia?

A
  1. Carprofen (Rimadyl)

2. Meloxicam (Metacam)

37
Q

What are some adverse side effects from using acetaminophen in cats?

A
  • Hepatotoxicity

- Hemolytic anemia

38
Q

What are some other adverse effects of NSAIDs?

A
  • Increase gastric acid secretion and decrease gastric mucus production (GI ulceration/hemorrhage)
  • Renal toxicity (decrease renal blood flow)
  • Liver damage
  • Antagonize action of certain drugs
  • May impair platelet function
39
Q

What drugs can NSAIDs antagonize?

A
  • ACE inhibitors

- Diuretics

40
Q

What are 3 alpha-2 adrenergic agonists used for analgesia?

A
  • Xylazine
  • Medetomidine
  • Ketamine
41
Q

Medetomidine produces ______ _____ effects, ________ sedation, and potentially __________ side effects.

A

Short term effects; profound sedation; potentially serious side effects.

42
Q

T or F: Analgesics drugs should never be prescribed into the post-operative period when the patient goes home.

A

False; Analgesic drugs should be prescribed into the post-operative period.

Surgery (3 decks)

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