Treatment of Acute Pain Flashcards
what can trauma pain involve?
bruising
hemorrhage
bone fracture
massive soft tissue damage
wound contamination
what is preventative analgesia striving for?
minimizing sensitization induced by noxious stimuli arising throughout the perioperative period
what is multimodal analgesia?
drugs (or methods) that work at different mechanistic levels
target multiple sites along somatosensory system
why does illness complicate acute pain treatment?
cannot show same responses to pain as healthier patients
disease state: some medications riskier
what are the main side effects of opioids?
behavioral alterations
gastrointestinal
respiratory depression
urine retention
what types of pain are NSAIDs effective against?
inflammatory pain
neuropathic pain
when can you use ketamine?
intra-op
post-op/non-surgical acute pain
any time patient might be behind on analgesia
what are the goals of acute pain treatment?
prevent or reduce to level patient can cope with physiologically and emotionally
not to remove all pain
avoid or recognize adverse analgesic effects
does the animal’s affective state affect the amount of surgical pain?
yes
what can you give with opioids for multimodal analgesia?
NSAID
local anesthetics
ketamine
gabapentin
when should you give opioids?
intra-op
post-up, or non-surgical acute pain
how do local anesthetics decrease pain?
peripheral and central inhibition of Na channel
what is ketamine?
NMDA receptor antagonist
prevents opioids tolerance
may decrease central sensitization even at lower doses/single bolus
what are the major side effects of ketamine?
muscle rigidity
dysphoria
sedation/catalepsy
hallucination?
where do alpha2 agonists act?
brainstem, dorsal horn spinal cord, periphery to decrease pain signals
locus coeruleus: brainste, sedation
dorsal horn: reduce release substance P from C fibers
