DM1 Pt7-3 Pre-emptive & Muli-modal Analgesia Flashcards
What is pre-emptive analgesia?
Pre-emptive analgesia is the administration of analgesic drugs before the onset of pain or increased afferent input to the spinal cord, with the goal of reducing or preventing the development of central sensitization.
Why is pre-emptive analgesia more difficult to provide in clinical settings?
It is challenging to block all afferent input from large surgical wounds, making it hard to completely prevent central sensitization. Additionally, pain is difficult to quantify, especially in animals.
What is preventive analgesia, and how does it differ from pre-emptive analgesia?
Preventive analgesia involves administering analgesics early (before pain starts) and for an adequate duration after surgery to prevent central sensitization. It focuses on maintaining analgesia for a longer period post-surgery.
Why is pre-emptive and preventive analgesia still recommended despite limited clinical evidence?
Clinical pain management strategies advocate using these techniques because they can reduce pain sensitivity and improve post-operative pain management, even if the benefits are difficult to quantify in studies.
What is an example of pre-emptive analgesia in a cat undergoing surgery?
A common strategy includes premedication with dexmedetomidine and buprenorphine, and administration of an NSAID (e.g., meloxicam) at induction of anesthesia before surgery begins.
What is multi-modal analgesia?
Multi-modal analgesia involves using different classes of analgesic drugs in combination to target multiple receptors and pathways in the pain process, providing more effective pain relief than a single drug class alone.
Why is multi-modal analgesia more effective than using a single drug class?
The pain pathway involves multiple receptors and neurotransmitters, so targeting multiple sites using different classes of drugs can provide better pain relief.
What is an example of a multi-modal analgesia technique for a cat undergoing surgery?
Using an opioid (e.g., buprenorphine) for quick onset and short duration, and an NSAID (e.g., meloxicam) for slower onset but long duration, provides effective, balanced analgesia.
Why should two drugs from the same class (e.g., two NSAIDs) not be combined in multi-modal analgesia?
Combining two drugs from the same class, like two NSAIDs, can lead to an overdose and increase the risk of harmful side effects.
What is an example of combining local anesthetics with opioids in a multi-modal technique?
Combining an epidural local anesthetic (e.g., bupivacaine) and morphine with systemic administration of an opioid and an NSAID for a cat undergoing femoral fracture repair provides effective pain relief at multiple levels of the pain pathway.
