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Veterinary Nursing Anaesthesia and Analgesia > Pain Management > Flashcards

Pain Management Flashcards

(50 cards)

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1
Q

What is pain?

A
  • Sensory experience associated with tissue damage

- Emotional component in humans and animals

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2
Q

Forms of pain management? (3)

A
  • Analgesia
  • Multi-modal analgesia
  • Pain scoring methods (pain behaviour)
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3
Q

Why should pain be avoided? (Mention 4 things)

A
  • Stress to patient
  • Prolonged recovery
  • Poor or delayed wound healing
  • Self-trauma
  • Impairs respiratory and cardiovascular function
  • Reduced food intake
  • Reduced mobility
  • Our ethical responsibility!
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4
Q

Name 3 responses to pain

A
  • Intra-operative pain
  • Increased HR
  • Increased RR
  • Dilation of bronchi
  • Adrenaline release
  • Cardiac arrhythmias due to adrenaline release
  • Dilation of blood vessels in skeletal muscle
  • Constriction of blood vessels in gastrointestinal tract
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5
Q

What is acute pain associated with?

A

Injury / trauma

- may be post surgical

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6
Q

When does acute pain usually abate

A
  • as healing occurs
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7
Q

What is acute pain?

A

Pain that does not usually outlast the initial painful stimulus

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8
Q

What is chronic pain?

A

Pain that does outlast the initial painful stimulus
OR
British pain society: ‘pain lasting longer than 12 weeks’
OR
pain lasting longer than anticipated

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9
Q

What can chronic pain cause changes in

A
  • Can cause changes in pain pathways of the central and peripheral nervous system
  • Continued pain can lead to changes in the way the animal responds to painful stimulus
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10
Q

What is pre-emptive analgesia

A

Administration of analgesics prior to pain stimulation preventing neuron sensitisation

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11
Q

What are the three kinds of pain?

A
  • Physiological
  • Inflammatory
  • Neuropathic
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12
Q

What is physiological pain?

A

Response that is proportionate to stimulus and pain goes when stimulus is removed
- ‘Protective pain’

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13
Q

What is inflammatory pain?

A

Clinical pain
- caused by surgery?
inflammation

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14
Q

What is neuropathic pain?

A

Caused by direct damage to the nervous system

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15
Q

What is the physiology of pain

A
  • Noxious (painful) stimulus associated with tissue damage and release of inflammatory mediators leading to the activation of pain receptors in nociceptors
  • Nociceptors transmit pain signals to CNS
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16
Q

What can repeated stimulus of pain pathways cause?

A

Heightened sensitivity

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17
Q

What are nerve endings that detect painful stimuli called?

A

Nociceptors

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18
Q

What are the main inflammatory mediators?

A

Prostaglandins

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19
Q

What is transduction

A

Pain being detected by nociceptors that then convert the painful stimulus into a nervous signal

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20
Q

What are the pain fibres?

A

Að and C

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21
Q

What is the aim of analgesia?

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A

To interrupt or modify some or all parts of the CNS pathway

22
Q

What can ongoing pain cause?

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A

Chronic hypersensitivity to pain that can outlast the actual pain event

23
Q

What is Allodynia?

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A

Sensitivity to stimuli that would not normally cause pain e.g. touch

24
Q

What is hyperalgesia

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A

Greater intensity and duration of pain that would be expected

25
What 5 kinds of drugs are most commonly used
``` Opioids NSAIDs Alpha-2-adrenoreceptor agonists Local anaesthetics Ketamine Gabapentin ```
26
Name 2 opioids used for analgesia and pain management
Methadone Buprenorphine Fentanyl
27
Where do opioids act?
Centrally and peripherally
28
How do NSAIDs work?
Inhibit the production of inflammatory mediators via the inhibition of COX enzymes
29
What kind of NSAIDS are safer for the gut?
Cox-2 selective
30
Name 3 NSAIDs commonly used
``` meloxicam Carprofen Robencoxib Asprin Phenybutazone Ketoprofen Paracetamol ```
31
What are NSAIDs used for
Management of chronic pain | Peri-operative pain relief
32
When should you avoid NSAID usage? (name 2)
In patients that are: - Dehydrated - Hypotension (Shocked) - Have pre-existing renal disease - Liver disease - Animals already on corticosteroids or other NSAIDs
33
Name 2 Alpha-2-adrenoreceptor agonists
medetomidine dexmedetomidine Xylazine
34
What is used to reverse Alpha 2's
Atipamezole
35
Name a local anaesthetic used for pain management
Lignocaine Bupivicaine Mepivicaine
36
What kind of analgesia do local anaesthetics provide?
Total analgesia
37
What type of analgesia does ketamine provide
somatic analgesia
38
Why is ketamine used for pain management
- thought to prevent 'wind up' | - acts centrally and can block central sensitisation
39
When is Gabapentin used for pain management?
To block neuropathic pain in adult animals
40
What is neuropathic pain
Pain caused by disease of sensory nerves
41
What is a disadvantage of gabapentin
Cost | Exact mechanism of action is unknown
42
Why is acupuncture used?
- For chronic pain | - To compliment pharmaceutical measures in pain patients
43
What are NSAID's often combined with to create multi-modal analgesia? (name 1)
- Opioids - Alpha-2-agonists - Local anaesthetics
44
What kind of 'infusion' is often avoided in cats and why
'Milk' infusions due to sensitivity to lidocaine
45
What is a 'milk' infusion'
combo of: - NaCl 0.9 or Hartmanns - Morphine - Lidocaine - Ketamine
46
What variables can cause a variation in pain behaviour?
``` Species Breed Age Sex Temperament ```
47
Name 2 scales used to determine pain?
- Simple descriptive scale - Numerical rating scale - Visual analogue scale - Glasgow composite pain scale - Colorado pain scale for cats
48
Why are pain scales made?
To standardise and improve pain management
49
How do you determine if it pain or a stormy recovery?
Palpation of would: Should elicit painful or heightened response - Painful animals may be temporarily distracted unlike those who are dysphoric
50
Name 4 additional roles of the VN to enhance a smooth recovery, and pain management
- Monitor - Record and report signs of pain - Give good nursing care - Give clean warm bedding - Tend to wounds e.g. bandaging - Comfortable environment - Allow toileting and eating as close to normal - Provide psychological support

Veterinary Nursing Anaesthesia and Analgesia (25 decks)

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