Pain Management and Analgesia

Question 1

Define anesthesia

Answer 1

central nervous system depression resulting in amnesia, unconsciousness, lack of sensation, and immobility in response to painful stimulus

Question 2

Define analgesia

Answer 2

absence of pain in response to painful stimulation

Question 3

Define sedation

Answer 3

state of mental calmness, decreased response to environmental stimuli, and muscle relaxation

Question 4

Signs of acute pain in cats

Answer 4

-Quiet/immobile, decreased social interactions
-Sensitive to touch
-Hiding
-Excessive licking/chewing at site
-Hyperventilation, tachycardia, hypertension
-Hunched posture

Question 5

Signs of chronic pain in cats

Answer 5

-Reduced activity
-Disinterest in the environment
-Anorexia and weight loss
-Poor grooming
-Lameness/gait abnormalities

Question 6

Signs of acute pain in dogs

Answer 6

-Vocalization (whimpering)
-Disinterest/withdrawn
-Aggression
-Comfort seeking
-Reluctant to move
-Rapid shallow breathing (panting)
-Guarding injury/apprehensive
-Restlessness

Question 7

Signs of chronic pain in dogs

Answer 7

-Weight loss
-Depression and lethargy
-Reduced appetite
-Muscle atrophy
-Lameness/gait abnormality

Question 8

Signs of pain in rabbits

Answer 8

-apprehensive, dull, inactive, and “hunched” appearance
-Aggressive behavior and increased excessive scratching and licking
-Exaggerated reactions to handling
-Increased respiratory or change in feeding activity

Question 9

Signs of pain in rodents

Answer 9

-Decreased activity, piloerection un-groomed appearance, or licking and scratching
-Abnormal stance with ataxia and may become aggressive with handling
-Vocalization
-Inappetence or change in feeding and change in normal group behavior

Question 10

Signs of pain in birds

Answer 10

-Escape reactions with vocalization and excessive movement
-Increased heart and respiratory rates
-Inappetence and inactivity with drooping, miserable appearance
-When handled, escape reaction replaced by a state of tonic immobility

Question 11

Define nociception

Answer 11

Processing a noxious stimulus (mechanical, thermal, or chemical) resulting in perception of pain by the brain

Question 12

Define nociceptors

Answer 12

-Receptors in neurons which are activated through various noxious stimuli
-Exist at the free nerve endings of primary afferent neurons
-Encapsulated

Question 13

Where is the only place in the body that pain receptors are not found?

Answer 13

The brain

Question 14

When does nociceptive pain occur?

Answer 14

When peripheral neural receptors are activated by noxious stimuli (surgical incisions, trauma, heat, or cold)

Question 15

List the steps of nociception

Answer 15

1. Transduction
2. Transmission
3. Modulation
4. Perception

Question 16

Define Transduction

Answer 16

-Conversion of noxious stimulus into electrical energy by a peripheral nociceptor
-Can be inhibited by NSAIDs, opioids, and local anesthetics

Question 17

Define Transmission

Answer 17

-Propagation through the peripheral nervous system via first-order neurons
-Transmission to the spinal cord
-Reduced by local anesthetics and alpha2 agonists

Question 18

Define Modulation

Answer 18

-When first order neurons synapse with second-order neurons in the dorsal horn cells of the spinal cord
-Influenced by local anesthetics, alpha-2 agonists, opioids, NSAIDs, TCAs, and NMDA receptor antagonists

Question 19

Define Perception

Answer 19

-Cerebral cortical response to nociceptive signals projected by third-order neurons to the brain
-Inhibited by general anesthetics, opioids, and alpha-2 agonists