Pain Flashcards
Define pain.
An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual and potential tissue damage.
Define nociception.
The neural process of encoding noxious stimuli.
Define nociceptive pain.
Pain that arises from actual or threatened damage to non-neural tissue and is due to the activation of nociceptors.
Define neuropathic pain.
Pain caused by a lesion or disease of the somatosensory nervous system.
Define hyperalgesia and give an example.
Increased pain from a stimulus that normally provokes pain.
E.g. palpation normally vs. when bruised
Define allodynia and give an example.
Pain due to stimulus that does not normally provoke pain.
E.g. no longer being able to tolerate being stroked.
What is the difference between acute and chronic pain?
Acute pain lasts a short period of time (minutes/hours to weeks)
Chronic pain lasts longer than a few weeks
What is the biological function of acute pain?
Protective up to a point - e.g. stop an animal walking on a broken leg.
What is the importance of quantification of pain?
Allows categorisation of pain / assessment of treatment efficacy / judgement-making about quality of life.
What are the physiological signs associated with pain?
Increased HR, BP and temp.
Altered respiration
Stress hormones
EEG activity
What signs of pain do both cats and dogs exhibit?
Hunched appearance Pain face Lack of grooming Inappetence Condition-specific signs
What signs of pain do cats exhibit?
Absence of normal behaviour repertoire Hide away at back of cage Unwilling to relax Fear-aggression Resent human contact
What signs of pain do dogs exhibit?
Positive behavioural signs rather than reduced repertoire
More likely to seek attention
Submissive
May be more likely to vocalise
What pain signs might a rabbit exhibit?
Immobility Depression Not grooming Eyes half-closed/shut Bruxism Abnormal body position Change in temperament
What pain signs might a horse exhibit?
Low head carriage Vocalisation Agitation Tail swishing Lameness/limb lifting Pain face Bruxism Muscle fasciculations
List the 7 signs that indicate chronic pain in all species.
Changes in normal behaviour Unkempt coat Loss of body condition/weight loss Slowing down/sleeping more OR more fidgety/restless Signs associated with reluctance to move Difficulty in accessing higher places
What four ways can you score acute pain?
Numerical rating scale
Visual analogue scale
Simple descriptive scale
Dynamic interactive visual analogue scale
What is the issue associated with acute pain score scales?
Inter-observer variation.
Explain the canine composite pain score.
Score out of 20 (dog can’t stand) or 24 (if dog can stand)
Intervention level is 5/20 or 6/24
Explain the feline composite pain score.
Maximum score is 20
Intervention level is 5/20
How do we score chronic pain and why?
Health-related quality of life scoring - shows pattern of pain and wider effects, brings in additional items such as appetite/sleep, includes pain over a period of time (e.g. 7 days).
Why is assessment of health-related quality of life important?
Aids decision-making about analgesia and euthanasia
Improved patient wellbeing through holistic care
Improves continuity of treatment
Helps build and maintain vet-owner relationships
Describe preventative analgesia.
Admin before, during and after procedure
Causes a reduction in intensity/duration of acute pain, and a reduction in chronic pain
Describe multimodal analgesia.
Use of different classes of analgesic agents
Leads to more effective analgesia with lower doses of agents
