Analgesia Techniques

Question 1

What are the classes/types we use for paraenternal analgesia?

Answer 1

NSAIDS

CRI drugs

Question 2

What do we use for local/regional anestheisa?

Answer 2

select nerve blocks

Eipdural, lumbosacral caudal epidural

wound infusion catheters

Question 3

List the 6 common NSAIDS

Answer 3

Carprofen
Deramaxx
Meloxicam
Robenacoxib
Phenylbutazone
Flunixin

Question 4

What is Fentanyl?

Answer 4

Dogs, cats
Intra-Op analgesia
**Dose dependent/MAC sparing (up to 65%)
'one' dimensional analgesia
watchout for bradycardia

Question 5

What is MLK?

Answer 5

Morphine, Lidocaine, Ketamine

multimodal analgesia

Question 6

What pain pathways does morphine block?

Answer 6

Transduction
Modulation
Preception

Question 7

What type of apin is morphine useful for?

Answer 7

Visceral pain

Question 8

______ is the backbone of mist/all analgesic protocols

Answer 8

Morphine

Question 9

Lidocaine blocks which pain pathways?

Answer 9

transduction, transmission, modulation

Question 10

Why is lidocaine included in multimodal analgesia?

Answer 10

anti inflammatory, central analgesia properties with CRI

decrease cardiac/cerebral ischemia- reperfusion injury

Question 11

How does lidocaine prevent cardiac/cerebral ischemia- reperfusion injury (mechanism)

Answer 11

prevents intracellular Na+ overload & through its anti-inflammatory properties

Question 12

Ketamine blocks ____ pain from____

Answer 12

somatic pain from bones, joints, ligaments skin

Question 13

Ketamine modualtes the spinal pathways via:

Answer 13

Blocks NMDA receptors

decreases central sensitization/wind up

Prevents secondary hyperalgesia

Chronic pain

Question 14

Describe the mechanism of Ketamine central sensitization:

Answer 14

frequent/sever activation of Alpha-Delta nociceptors

increased exitatory neurotransmitters (glutamate/subs P)

activates NMDA, NK, AMPA receptors

increased signal molecules, gene expression, neuroplasticity

Question 15

When the Alpha-Beta mechanoreceptors are activated, NON-painful stimuli contribute to the pain response, a condition known as _____

Answer 15

Secondary Hyperalgesia

Question 16

How does Ketamine offer neuroprotection?

Answer 16

via NMDA blockade

decrease Ca influx =>
increased cell intergrity, survival, regeneration

Question 17

T/F MLK is commonly used at ISU, and given as a either a CRI or SQ Bolus

Answer 17

FALSE

DO NOT BOLUS THIS

Question 18

What is the CRI for MLK ?

Answer 18

Infuse @ 5mls/kg/hr for first hr

then reduce to 2.5 mls/kg/hr

Question 19

T/f MLK is not very effective at MAC sparing

Answer 19

FALSE
decreases the MAC of ISO by 45%
many patients on

Question 20

T/F Because of its MAC sparing effects, patients on MLK should be monitored closely

Answer 20

TRUE, monitor EtCO2

have IPPV available

Question 21

Describe how to recover animals from MLK

Answer 21

Wean from IPPV, monitor EtCO2
10 min O2 support after vaporizer off
Monitor SpO2, keep above >93-95% w/ o2 supplementation
+/- partial reversal if prolonged O2 dependence

Question 22

What reversal agent would you use for MLK?

Answer 22

butorphanol, given in 0.2 ml increments

Question 23

What is the difference between MLK and HLK

Answer 23

one letter dumb ass

Hydropmorphone

Question 24

What ‘benefits’ does hydromorphone offer in sedation

Answer 24

Clinical impression-

less sedation, more vocalization/dysphoria at recovery

Question 25

What is in the concoction F + LK?

Answer 25

Fentanyl, lidocaine, ketamine

Question 26

What is the benefit of F+LK

Answer 26

more control/titration of opiod dose

retain multi-multiple neuroprotective and/or anti-inflammatory effects of L&K

use Fentanyl in syringe pump, add LK to IV fluid