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anaesthesia > pain management > Flashcards

pain management Flashcards

1
Q

pain

A

unpleasant physical and or emotional experience, associated with potential or actual tissue damage

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2
Q

analgesia

A

reduce perception of pain

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3
Q

nociception

A

experience of pain through the brains cerbral cortex

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4
Q

noxious stimuli

A

a stimulus that causes pain

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5
Q

noiciceptor

A

sensory receptor that responds to damaging or potentially damaging stimuli by sending electrical signals to the spinal cord and brain

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6
Q

pre emptive analgesia

A

pain relief given that is appropriate to the anticipated pain before procedure is carried out to prevent pain establishing

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7
Q

multimodal analgesia

A

the use of different classes of drugs in combination to desensitise multiple pain pathways

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8
Q

wind up

A

perceived increase in pain intensity overtime when a stimulus is delivered repeatedly above a critical rate

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9
Q

sensitisation

A

decrease in pain threshold and an increase in the magnitude of the response to noxious stimulation

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10
Q

hyperalgesia

A

an increased sensitivity to pain

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11
Q

transduction

A

translating noxious stimuli into nociceptive impulses

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12
Q

transmission

A

movement of impulses via nerve endings to spinal cord and then to the brain

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13
Q

modulation

A

process of amplification or dampening of nociceptive signals

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14
Q

perception

A

subjective experience of pain and how it is experienced

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15
Q

patient experience of pain

A

worsen experience during hospital stay, increase stress and fear

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16
Q

client experience of pain

A

added cost, admin of pain meds

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17
Q

recognition of pain - behavioural

A

restlessness
posture
gaurding
licking
lame
vocalisation
hiding
agression
decreased appetite

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18
Q

recognition of pain - physiological

A

tachycardia
hypertension
pupillary dialation
hyper salivation
hyperthermia
elevation in parameters

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19
Q

pain assesment

A

pain scoring
HR
vocilisation
movement
restlesness

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20
Q

treating pain

A

pre emptive pain relief
multimodal
reassess pain every 2-4hrs

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21
Q

opioid binding

A

bind to receptors in the CNS, GIT, urinary tract and smooth muscle

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22
Q

opioid receptors

A

mu, delta, kappa

23
Q

full agonist

A

produce an effect when combined with a receptor

24
Q

antagonist

A

do not produce an effect when combined with a receptor

25
Q

partial agonist

A

produce some effect when combined with a receptor

26
Q

mixed agonist and antagonist

A

has effect on some receptors but not on others

27
Q

adverse effect of opioids

A

respiratory depression, reduced cough reflex, less responsive to co2 levels
increased intra cranial pressure - vasodialation
vomiting - stimulate chemoreceptor trigger zone
bradycardia
dogs- pin point pupils
cats-dialated pupils
histamine release

28
Q

opioids licenced for use

A

morphine, fentynl, methadone, butorphanol, buprenorphine, naloxone

29
Q

morphine

A

gold standard
high affinaty to mu receptor
class b controlled drug
4hr duration
SQ, IM, IV

30
Q

fentaynl

A

full mu agonist
potent analgesic with short action
SQ, IM, IV, patches
class b controlled drug

31
Q

methadone

A

full agonist
lasts 3-4hrs
no emetic effect
SQ, IM, IV

32
Q

buprenorphine

A

partial mu agonist
mild-moderate analgesia
used in combinations
slow onset
lasts 6-8hrs
ceiling effect
class c controlled drug

33
Q

naloxone

A

reverse effects of opioids
only used in overdose

34
Q

NSAIDS

A

anti inflamatory, anti pyretic, analgesic
inhibitation of the COX enzyme
acute and chronic pain management

35
Q

NSAIDS advantages

A

long duration
non behaviour modifying
lack of cardiopulmonary side effects

36
Q

COX 1

A

maintain renal and gastrointestinal mucosal blood flow
aids platelet aggregation and blood clotting

37
Q

COX 2

A

produce prostaglandins responsible for inflammatory response

38
Q

adverse effects of NSAIDS

A

GI ulceration
v + d
kidney failure and acute renal failure
synergy with corticosteroids

39
Q

NSAIDS contraindications

A

impared renal or hepatic function
dehydration
corticosteroids
GI ulcers
pregnant animals

40
Q

NSAIDS licensed for use

A

carprofen
meloxicam
firocoxib

41
Q

local blocks

A

dental nerve blocks
limb nerve blocks
infiltrative techniques
topical
intra articular
epidural

42
Q

advantage of local regional analgesia

A

block transmission of pain
reduce dose of other drugs
minor sx in conscious animals
addition to GA
post op analgesia

43
Q

potential complications of local regional analgesia

A

systemic toxicity if IV
nerve injury
block wrong nerve

44
Q

local

A

lidocaine
mepivicaine
bupivicaine

45
Q

ocular drops

A

can damage cornea if repeated

46
Q

local transdermal patched

A

care with temp

47
Q

dental blocks

A

infraorbital
mandibular
maxillary

48
Q

limb nerve blocks

A

distal limb ring block
brachial plexus nerve block
sciatic nerve block

49
Q

intra articular blocks

A

injected into a joint to treat joint pain
combined with steroid to reduce inflamation
hip
elbow
stifle
carpus
tarsus

50
Q

epidural benefits

A

L6-L7 or L7-S1
combination of local and opioid
muscle relaxation
loss of hind limb motor function
long duration
cheap

51
Q

epidural adverse effects

A

hypotension
urinary retention
accidental spinal anaesthesia
training required

52
Q

gabapentin

A

anti anxiety
managment of neuropathic pain

53
Q

ketamine

A

dissociative anaesthetic
analgesic properties
altered behaviour in recovery

anaesthesia (10 decks)

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