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Anaesthesia > Pain Management > Flashcards

Pain Management Flashcards

1
Q

Why do we want to avoid pain?

A
  • prolongs recovery
  • poor or delayed wound healing
  • self trauma
  • impairs respiratory and cardiovascular function
  • reduces food intake
  • reduces mobility
  • ethical responsibility
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2
Q

What physiological responses are caused by pain?

A
  • Sympathetic NS response
  • Increased HR
  • Increased RR
  • Dilation of bronchi
  • Adrenaline release causes cardiac arrhythmias
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3
Q

What is the difference between chronic and acute pain?

A

Acute pain does not usually outlast the initial painful stimulus, whereas chronic pain does. (chronic pain cane defines as pain lasting longer than 12 weeks)

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4
Q

Define analgesia

A

Loss of sensitivity to pain or ABSENCE of pain . Only absolute analgesic is a local anaesthetic

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5
Q

Define Hypoalgesia

A

Reduction of pain

- more accurate term

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6
Q

What is the goal of pre-emptive analgesia

A

Prevent neuron sensitisation

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7
Q

Describe the physiology of pain

A

Painful stimulus causes release of inflammatory mediators and activation of nociceptors (pain receptors).
These then transmit pain signals to the CNS via pain pathways. This is then where the perception of pain occurs.

Repeated stimulus of pain pathways can cause heightened sensitivity

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8
Q

What is the aim of analgesia?

A

To interrupt or modify the pain pathway and block the perception of pain

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9
Q

Define Allodynia

A

Sensitive to stimuli that would not normally cause pain (i.e. touching an area that isn’t painful but getting a response that would indicate it was!)

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10
Q

Define Hyperalgesia

A

Greater intensity and duration of pain than would be expected

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11
Q

Describe Methadone

A
  • Full agonist
  • licensed for dogs and cats
  • Used for moderate to severe pain e.g. spay, fracture
  • Provides analgesia and some sedation
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12
Q

Describe Buprenorphine

A
  • Partial agonist
  • Reaches analgesic plateau (increasing dose does not increase analgesia)
  • For mild to moderate pain e.g. superficial surgeries
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13
Q

What are NSAIDs mostly used for?

A
  • Perioperative pain relief
  • Management of chronic pain
  • They block
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14
Q

What are side effects of NSAIDs

A
  1. Renal
    - Prostaglandins maintain glomerular and renal blood flow so NSAIDs may lead to renal dysfunction or failure
  2. GIT
    - COX1 responsible for mucus secretion and maintaining blood flow to the gut. NSAIDs may cause gastric ulceration
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15
Q

When are NSAIDs contraindicated?

A
  • Hypotension
  • Dehydration
  • Pre-existing renal disease
  • Liver disease (risk of overdose as metabolised by liver)
  • Animals already on steroids or NSAIDs
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16
Q

Give some examples of NSAIDs

A
  • Meloxicam
  • Aspirin
  • Carprofen
  • Paracetamol (TOXIC to cats)
17
Q

What is the only true painkiller?

A

Local Anaesthetics - block nociceptive impulses

18
Q

Give some examples of local anaesthetics

A
  • Bupivicaine
  • Mepivicaine
  • Lignocaine (lidocaine)
19
Q

Describe what alpha 2 adrenoreceptor agonists are

A

Sedative drugs with analgesic effects

- used in lower doses for ONLY analgesia

20
Q

Give examples of alpha 2 adrenoreceptor agonists

A

Medetomidine and Dexmedetomidine

21
Q

What can you use to reverse alpha 2 adrenoreceptor agonists?

A

Atipamezole

22
Q

What is Gabapentin used for?

A

Used to treat neuropathic pain

23
Q

Describe what ketamine is? and what it does?

A

Dissociative anaesthetic

  • provides somatic analgesia
  • used at lower doses for analgesia only
  • acts centrally and helps prevent hypersensitivity build up by blocking central sensitisation
24
Q

What is multi-modal analgesia?

A

The use of multiple drugs incorporating different pharmalogical actions to produce optimal analgesia
i.e. to interrupt the pain pathway at multiple points)

25
Q

List some signs of pain in dogs and cats

A
  • Chewing/licking
  • Aggression or change in temperament
  • Vocalisation
  • Cowering at back of cage
  • Anorexia
  • Panting
  • Hunched
  • Prayer stance
26
Q

List some signs of pain in small mammals

A
  • anorexia
  • teeth grinding
  • hunched up
  • dull
  • reluctance to move
  • aggression
  • chewing at wound
  • limping
  • facial expression
  • vocalisation if severe
27
Q

How would you differentiate if a patient is painful or dysphoric upon recovery?

A
  • palpation of wound

- painful animals can be temporarily distracted

28
Q

What other things can contribute to pain management alongside analgesic drugs?

A
  • good nursing care
  • clean, warm bedding
  • appropriate bandages
  • comfortable environment
  • keeping habits as close to normal as possible
  • support ( reassurance)

Anaesthesia (15 decks)

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