Perioperative Pain Management

  1. What are some different signs of pain?
    • elevated HR and RR
    • dilated pupils
    • excess salivation
    • guarding painful area
    • vocalizing
    • licking area
    • sleeplessness
    • trembling
    • decreased response to owner
    • restlessness
  2. What do animals do when they are comfortable after surgery?
    • sleep
    • yawn
    • groom
    • cats use litterbox
  3. What can dogs and cats do that we can confuse with happiness when they are really in pain?
    • dogs:  wag their tails
    • cats:  purr
  4. What is the purpose of preemptive analgesia?
    • blocking the pain pathway before the painful stimulus
    • the noxious stimuli are still causing wind-up which may lead to exaggerated pain upon recovery
  5. What does multimodal analgesia refer to?
    use of analgesic drugs from multiple classes
  6. Why do we combine drugs from different classes?
    the doses of each individual drug can be lowered, reducing the adverse side effects of each
  7. Define agonist.
    a drug that binds to a receptor and stimulates a response
  8. Define allodynia.
    pain response to a normally innocuous stimulus
  9. Define analgesia.
    absence of pain sensation
  10. Define antagonist.
    a drug that blocks a receptor and prevents the response
  11. Define antipyretic.
    agent that reduces fever
  12. Define brachial plexus.
    network of nerves originating from the ventral branches of the last four cervical and the first thoracic spinal nerves; gives off principal nerves to shoulder and forelimbs
  13. Define buccal.
    pertaining to the cheek pouch
  14. Define central sensitization.
    hyperexcitability of pain perception in the spinal cord; also referred to as wind-up
  15. Define hyperalgesia.
    increased pain response caused by local inflammation
  16. Define mandible.
    lower jaw
  17. Define maxilla.
    upper jaw
  18. Define multimodal analgesia.
    providing analgesics from different drug classes
  19. Define nociceptor.
    nerve ending that responds to noxious stimuli
  20. Define opioid.
    the class of narcotic analgesics that are derived from opium
  21. Define preemptive analgesia.
    providing analgesics before the painful stimulus
  22. Define somatic analgesia.
    absence of pain sensation int he skin and musculoskeletal system
  23. Define sublingual.
    under the tongue
  24. Define visceral analgesia.
    absence of pain sensation in the internal organs
  25. What is another term for N-methyl-D-Aspartate (NMDA)?
  26. What are the two receptors that opioids bind to?
    u and k
  27. What is the body's natural opiate?
  28. Which opioids bind to the u receptors?
    • morphine
    • hydromorphone
    • oxymorphone
    • fentanyl
    • codeine
  29. Which opioids bind to the k receptors?
  30. What is the antagonist for opioids?
  31. What is buprenorphine?
    partial agonist for the u receptor
  32. Butorphanol is a k agonist but it is also a what?
    u antagonist
  33. Which provides a better analgesia, u or k agonists?
    u agonists
  34. Which lasts long for butorphanol, analgesia or sedative effects?  Why can it be a problem?
    • sedative effects
    • its a problem because an animal could be calm from the sedative effects but could still be experiencing pain
  35. Which NSAIDs are approved for dogs?
    • carprofen
    • deracoxib
    • etodolac
    • meloxicam
    • tepoxalin
  36. Which NSAID is approved for cats?
    a one time injection of meloxicam
  37. What should we do when an animal is administered an NSAID preoperatively?
    be put on fluids during anesthesia and monitor blood pressure
  38. What the local anesthetics we use?
    • lidocaine
    • bupivacaine
  39. What do local anesthetics do?
    inhibits nocicpetors, preventing transmission of painful stimuli and spinal wind-up
Card Set
Perioperative Pain Management