Untreated Pain Effects Quiz
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Questions and Answers

What physiological effects can sympathetic stimulation from untreated pain lead to?

  • Enhanced immune system response
  • Increased digestive enzyme production
  • Decreased heart rate and blood pressure
  • Increased cardiac work and oxygen consumption (correct)
  • Which of the following is a consequence of untreated pain related to the immune system?

  • Increased leukocyte production
  • Immune system suppression (correct)
  • Immediate immune response activation
  • Immune system enhancement
  • Which stress response is primarily mediated by the sympathetic nervous system due to pain?

  • Decreased hormone release
  • Stable glucose levels
  • Reduced heart rate
  • Increased cortisol and epinephrine release (correct)
  • What is a common psychological consequence of untreated pain?

    <p>Anxiety and suffering (C)</p> Signup and view all the answers

    What is NOT included in the patient pain assessment checklist?

    <p>Determining the patient's favorite activities (B)</p> Signup and view all the answers

    Which pain assessment tool involves scoring based on psychological and behavioral criteria?

    <p>CSU Canine Acute Pain Scale (C)</p> Signup and view all the answers

    What physiological complication can occur in the renal system due to untreated pain?

    <p>Urinary retention (C)</p> Signup and view all the answers

    Which consequence can occur in the cardiovascular system as a result of untreated pain?

    <p>Tachycardia and hypertension (D)</p> Signup and view all the answers

    What is the primary goal of analgesia?

    <p>To reduce pain by interrupting nociception (C)</p> Signup and view all the answers

    Which of the following describes multimodal therapy?

    <p>Targeting multiple pain receptors and mechanisms (B)</p> Signup and view all the answers

    At what pain score should the analgesic plan be reassessed for animals?

    <p>2-4 (C)</p> Signup and view all the answers

    What is the importance of allowing an animal to sleep post-surgery?

    <p>Sleep is crucial for recovery and healing. (B)</p> Signup and view all the answers

    What is an example of multimodal therapy for dogs?

    <p>Morphine combined with injectable NSAID (D)</p> Signup and view all the answers

    During which period is analgesia needed in animals?

    <p>Throughout the entire hospital stay and at home (C)</p> Signup and view all the answers

    Which of the following is NOT a component of the equine pain assessment scale for orthopedic issues?

    <p>Reaction to temperature changes (B)</p> Signup and view all the answers

    Why should animals not be evaluated for pain while they are sleeping?

    <p>Animals do not feel pain when sleeping. (D)</p> Signup and view all the answers

    Which factors influence the choice of analgesic drugs?

    <p>Severity and type of pain, patient condition, route of delivery (B)</p> Signup and view all the answers

    What physiological response is commonly triggered by pain in animals?

    <p>Fight-or-flight-freeze response (A)</p> Signup and view all the answers

    What behavior might indicate colic in horses according to the pain assessment scale?

    <p>Frequent lying down (A)</p> Signup and view all the answers

    Which of the following is NOT a component of nociception?

    <p>Memory formation (D)</p> Signup and view all the answers

    Which pain assessment scale is specifically tailored for post-abdominal surgery in horses?

    <p>Post Abdominal Surgery Pain Assessment Scale (PASPAS) (C)</p> Signup and view all the answers

    Which combination of drugs can be used to control pain in cats until the fentanyl patch takes effect?

    <p>Fentanyl and meloxicam (B)</p> Signup and view all the answers

    What aspect is NOT considered when using the post-abdominal surgery pain assessment scale (PASPAS)?

    <p>Grooming behaviors (B)</p> Signup and view all the answers

    What is evaluated in the composite orthopaedic pain scale for equines?

    <p>Behavioral changes (D)</p> Signup and view all the answers

    Which type of analgesics primarily act on opioid receptors in the body?

    <p>Opioids (D)</p> Signup and view all the answers

    What is the main action of non-steroidal anti-inflammatory drugs (NSAIDs)?

    <p>Inhibit COX-1 and COX-2 enzymes (C)</p> Signup and view all the answers

    Which of the following would be classified as a partial agonist at mu receptors?

    <p>Buprenorphine (C)</p> Signup and view all the answers

    How do local anesthetics primarily achieve analgesia?

    <p>By blocking sodium-gated channels (A)</p> Signup and view all the answers

    Which of the following is a characteristic of mu agonists?

    <p>They are the most potent analgesics (C)</p> Signup and view all the answers

    What is a common caution for the use of NSAIDs?

    <p>They may worsen gastrointestinal conditions (C)</p> Signup and view all the answers

    What is the role of alpha2-adrenergic agonists in analgesia?

    <p>To decrease the release of norepinephrine (D)</p> Signup and view all the answers

    How long should topical analgesia maintain contact for effectiveness?

    <p>20 to 30 minutes (B)</p> Signup and view all the answers

    What should be done when adding medication to a bag to maintain proportions?

    <p>Remove an equal amount from the bag. (B)</p> Signup and view all the answers

    Which of the following is NOT considered a non-pharmacologic intervention for pain management?

    <p>Opioid administration (B)</p> Signup and view all the answers

    Why is preemptive pain management important?

    <p>It anticipates pain before it occurs. (B)</p> Signup and view all the answers

    Which statement about patient pain perception is true?

    <p>Each patient may require different levels of analgesia. (D)</p> Signup and view all the answers

    What is one of the main responsibilities of effective pain management?

    <p>Monitoring cardiovascular status and mentation. (D)</p> Signup and view all the answers

    What differentiates dysphoria from anxiety?

    <p>Dysphoria involves unpleasant thoughts induced by drugs. (A)</p> Signup and view all the answers

    What is the consequence of not reassessing pain during a procedure?

    <p>It can lead to uncontrolled pain in the patient. (A)</p> Signup and view all the answers

    What is the most effective approach when a patient displays signs of undue pain during treatment?

    <p>Monitor the patient's status and adjust pain management. (B)</p> Signup and view all the answers

    How long will a 250mL bag last if it is administered at a rate of 15mL/hr?

    <p>16.67 hours (B)</p> Signup and view all the answers

    What is the appropriate dose in mg to add to the bag for a 20kg dog receiving hydromorphone at 0.01mg/kg/hr over 16.67 hours?

    <p>3.33 mg (D)</p> Signup and view all the answers

    How much of a 10mg/mL hydromorphone solution should be added to the bag to achieve the required 3.33mg dosage?

    <p>0.33 mL (C)</p> Signup and view all the answers

    If a 500mL bag is administered at a rate of 62mL/hr, what is its duration in hours?

    <p>8.06 hours (B)</p> Signup and view all the answers

    What is the total microgram (mcg) dosage required to be added to a bag for a 33kg dog receiving fentanyl at a rate of 2mcg/kg/hr over 8.06 hours?

    <p>531.96 mcg (B)</p> Signup and view all the answers

    How much of a 50mcg/mL fentanyl solution is needed to provide the required 531.96 mcg dosage in the bag?

    <p>10.64 mL (B)</p> Signup and view all the answers

    Determine the total volume in mL required to administer 50mcg/kg/min of lidocaine to a 30kg dog for 15.38 hours.

    <p>69.21 mL (D)</p> Signup and view all the answers

    How many minutes will a 1L bag last if it is administered at a rate of 65mL/hr?

    <p>922.80 minutes (D)</p> Signup and view all the answers

    What is the bag duration in hours when there is a 1000mL bag administered at a rate of 65mL/hr?

    <p>15.38 hours (A)</p> Signup and view all the answers

    When calculating drug dosage, which step is used to check that Rx units match concentration?

    <p>Set up equation and assess units (A)</p> Signup and view all the answers

    What do you need to do before adding medication to the fluid bag?

    <p>Remove the same volume of fluid from the bag (C)</p> Signup and view all the answers

    What is the effect of calculating dose in mcg/min while the fluid rate is in mL/hr on the overall calculations?

    <p>It necessitates conversions for accuracy before calculations. (A)</p> Signup and view all the answers

    Why is it important to convert mcg to mg when required in the calculations?

    <p>To ensure all doses are in compatible units. (D)</p> Signup and view all the answers

    If a drug dose is given in mcg/kg/min, which additional step must be taken when calculating the total dosage?

    <p>Convert to mcg/hr before calculating total dosage. (B)</p> Signup and view all the answers

    Flashcards

    Analgesia Goal

    Reducing pain by interrupting pain signals at one or more levels (transduction, transmission, modulation, and perception).

    Multimodal Therapy

    Using more than one drug to control pain—targeting multiple receptors and mechanisms of action to reduce individual drug doses and anesthetic agents.

    Examples of Multimodal Therapy

    Combining different medications like acetaminophen/codeine, fentanyl/meloxicam, or morphine/NSAID for varying pain levels and needs.

    Analgesic Therapy Stages

    Analgesia is needed throughout the entire hospitalization period, including pre-surgery, surgery, post-surgery, and recovery at home.

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    Analgesic Therapy Factors

    Choice of drug depends on pain severity, type, patient condition, and route of administration.

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    Signs of Pain in Animals

    Pain triggers a stress response, causing animals to display 'fight', 'flight', or 'freeze' physical responses.

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    Behavioral Pain Responses

    Animals show behavioral responses to pain, such as changes in posture, vocalizations, or reduced activity.

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    GABA

    A neurological component that influences heat, cold, stretching, and compression.

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    Untreated Pain Consequences

    Untreated pain in critical care patients can cause immune suppression, slower wound healing, increased anesthetic needs, and overall patient suffering.

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    Stress Response (Pain)

    Pain triggers a stress response through the sympathetic nervous system, leading to hormonal changes and neurotransmitter release that affect vital organs.

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    Cardiovascular Effects of Pain

    Untreated pain causes tachycardia (fast heart rate), hypertension (high blood pressure), and potential arrhythmias (irregular heartbeats).

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    Patient Pain Assessment Steps

    Assessing pain involves observing behaviors (like facial expressions), vital signs (heart rate, blood pressure, respiration), and palpating for painful areas.

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    Pain Assessment Tools

    Pain assessment can use various tools: visual analogue scales, numeric rating scales, specific pain scales for dogs/cats.

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    Pain Scale Criteria

    Pain scales consider behavioral responses, palpation responses, and body tension for a complete pain assessment.

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    Immune Suppression (Pain)

    Chronic pain can weaken the immune system, making the patient more susceptible to infections.

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    Delayed Wound Healing (Pain)

    Untreated pain can hinder the body's natural healing processes, leading to slower wound healing.

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    Colorado Pain Score

    A tool used to assess pain in dogs, cats, and horses based on several observable behaviors.

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    Sleeping Animal & Pain

    A sleeping animal, at least transiently, is not experiencing pain. Sleep is a crucial part of recovery and healing.

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    Feline Grimace Scale

    A tool to assess pain in cats by observing specific facial expressions and body postures.

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    PASPAS

    A pain scale used for horses after abdominal surgery, evaluating physiological, postural, interactive, and food-related behaviors.

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    Equine Pain Scale - Orthopaedic

    A scale used to assess pain in horses with orthopedic conditions, focusing on physical, behavioral, and treatment responses.

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    Analgesic Plan Reassessment

    Veterinarians are advised to review and adjust pain management plans for animals with a Colorado Pain Score of 2-4.

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    Pain Assessment in Animals: Why?

    Pain assessment is vital in veterinary practice to ensure animals receive appropriate pain management and promote optimal recovery.

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    Multimodal Analgesia

    A strategy combining different pain medications to target multiple pain pathways, which enhances pain relief and minimizes side effects.

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    CRI Dilution

    Adding medication to a bag/burette requires removing an equal volume to avoid dilution, maintaining accurate proportions. This should be done before priming to prevent multiple priming steps.

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    Nonpharmacologic Pain Management

    Using non-medicinal methods to address physical pain and emotional distress. This includes things like comfort, emotional support, distraction, and reassessing the patient's comfort level after addressing physical and emotional needs.

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    Analgesic Therapy: Non-Pharmacological (Examples)

    These are non-medicinal methods used to manage pain. Examples include good nursing care with proper hygiene and bandages, acupuncture, laser therapy, physical therapy, massage, and cold compresses or circulating ice water.

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    AAHA Pain Management Standards

    Guidelines for pain management in veterinary patients, emphasizing comprehensive pain assessment, preemptive pain management, appropriate pain management for expected pain levels and duration, and treatment of both acute and chronic pain.

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    Individualized Analgesia

    Each patient requires tailored pain management based on individual factors, and may need more analgesia than initially expected.

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    Opioid Reversibility

    Opioids are easily reversible, meaning their effects can be managed or eliminated if needed. It's easier to reduce pain management in a comfortable patient than to catch up on a patient experiencing pain.

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    Cardiovascular & Mentation Monitoring

    Closely monitoring cardiovascular status and mental state is crucial for effective pain management. It helps ensure that analgesics are effectively reducing pain without causing harmful side effects.

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    Supportive Care in Pain Management

    Providing comprehensive care beyond just medications. This includes managing complications and side effects of treatment, addressing pain and stress, and treating any adverse consequences.

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    Opioid Analgesics

    Pain relievers that work by attaching to and activating opioid receptors in the body, effectively reducing pain signals.

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    Mu Agonists

    Opioids that fully activate mu opioid receptors, providing the most potent pain relief.

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    Partial Agonists

    Opioids that partially activate mu receptors, offering some pain relief but less than full agonists.

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    NSAID Analgesics

    Pain relievers that act on both central and peripheral nervous systems, reducing pain, inflammation, and fever.

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    Local Anesthetics

    Pain relievers that block sodium channels in nerve fibers, preventing pain signals from traveling.

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    Topical Analgesia

    Applying pain relief directly to the skin or mucous membranes to manage minor procedure pain.

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    Alpha-2 Agonist Analgesics

    Pain relievers that decrease the release of norepinephrine, reducing pain signals in the brain and spinal cord.

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    NMDA Agonists

    Pain relievers that work on NMDA receptors involved in pain transmission and perception.

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    Drug Dosing Equation

    A formula used to calculate the precise amount of medication to add to an IV bag for a specific patient based on their weight, desired dose, and fluid rate.

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    Bag Duration

    The length of time an IV bag will last, calculated by dividing the bag's volume by the fluid rate.

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    Concentration

    The strength of a drug solution, expressed as the amount of drug per unit volume (e.g., mg/mL).

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    Units Match

    Ensuring that the units of measurement in the drug's dose, concentration, and time are consistent in the equation.

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    Replacing Hash Marks

    Changing division signs (/) to multiplication signs (*) in the drug dosing equation.

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    Converting mcg to mg

    Changing micrograms (mcg) to milligrams (mg) by dividing the mcg value by 1000.

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    Converting % to mg/mL

    Transforming a percentage (%) solution into a concentration of milligrams per milliliter (mg/mL).

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    Fluid Rate

    The speed at which fluid is being delivered from an IV bag, typically measured in milliliters per hour (mL/hr).

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    Dosage

    The amount of medication a patient receives, expressed as a rate per unit of weight and time (e.g., mg/kg/hr or mcg/kg/min).

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    Volume to Add

    The amount of medication solution (in mL) to add to the IV bag, determined by dividing the desired dosage by the drug concentration.

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    Rx Units Match Drug Concentration

    Ensuring that the units of measurement in the prescribed dose and the drug's concentration are compatible.

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    Rx Time Matches Fluid Rate

    Verifying that the time units in the prescribed dose and the fluid rate are consistent (typically both in hours or minutes).

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    Fluid Bag Volume

    The total volume of fluid contained in the IV bag, usually measured in milliliters (mL) or liters (L).

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    Remove Fluid from Bag

    The critical step of removing a volume of fluid from the IV bag equal to the volume of medication added to ensure the drug is properly diluted.

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    Study Notes

    Pain Physiology, Assessment & Treatment

    • Veterinary Nursing 2 course material
    • Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. The inability to communicate does not negate the possibility of experiencing pain.
    • Pain is a complex phenomenon and a subjective experience.
    • Pain elicits protective motor actions which leads to avoidance behaviours.

    Nature of Pain

    • Pain is a complex phenomenon described as an aversive sensory and emotional experience.
    • Protective motor actions are triggered, resulting in avoidance behaviours.
    • Species-specific behaviours may be altered.

    Physiology of Pain

    • Nociceptors are pain receptors in the nervous system.
    • Acute pain: Severe, sudden onset overwhelming endogenous analgesic mechanisms.
    • Chronic pain: prolonged and persistent pain, where the body becomes habituated to nervous system responses.

    Nociception vs Pain

    • Nociception is the process by which the nervous system detects potential or actual tissue injury.
    • Pain is the subjective experience of tissue damage, accompanied by awareness of that damage. Nociception might be present without pain (e.g. during anesthesia), while pain will always have nociception component.

    Nociception Pathway

    • Transduction
    • Transmission
    • Modulation
    • Perception

    Pathologic Pain

    • Pathologic pain is caused by damage or disease to the body, specifically tissue injury
    • Pain can be acute or chronic in nature.

    Classification of Pathologic Pain

    • Categories may be based on the mechanism of pain (inflammatory, neuropathic, cancer, or idiopathic)
    • Origin (visceral or somatic, superficial or deep)
    • Severity (none, mild, moderate, or severe).

    Types of Pain

    • Somatic pain originates from damage to bone, joint, muscle, or skin; is usually localized.
    • Visceral pain originates from internal organs and is poorly localized, from stretching or twisting of viscera, mesenteries, and ligaments.
    • Neuropathic pain originates from injury to the peripheral or central nervous system.
    • Inflammatory pain originates from tissue damage (e.g. trauma, ischemia, OA, laminitis).

    Other Pathologic Pain Types

    • Allodynia: Pain evoked by a stimulus that does not normally cause pain.
    • Hyperalgesia: An increased or exaggerated response to a stimulus normally causing pain.
    • Windup: Summation of painful stimulation in the spinal cord.

    Pain Assessment Tools

    • Simple descriptive scales
    • Visual analogue scales
    • Numerical rating scales
    • CSU Canine Acute Pain Scale
    • CSU Feline Acute Pain Scale
    • Categorical numeric rating scales

    Pain Assessment

    • Observe behaviours like anxious expression, facial expressions, restlessness, panting
    • Obtain heart rate, blood pressure, and respiration rate.
    • Palpate for painful areas.

    Pain Management

    • Goals of analgesia are to reduce pain and prevent undesirable effects on patient physiology
    • Use multimodal therapy, employing multiple drugs.
    • Treat pain at one or multiple levels during an animal's hospitalization (transduction, transmission, modulation, and perception).

    Consequence of Untreated Pain

    • Sympathetic nervous system stimulation contributes to vasoconstriction and increased cardiac work, heart rate and oxygen consumption.
    • Immune system suppression, delayed wound healing.
    • Risk of increased anesthesia doses and increased anesthetic risk.
    • Suffered increase patient pain.
    • Pain has significant negative effects on both physical and physiological parameters of the body.

    Analgesia Goal

    • Reduce pain by interrupting nociception at one or multiple levels.

    Multimodal Therapy

    • Use of more than one drug to control pain, covering multiple receptors and mechanisms.

    Types of Analgesics Targeted at Specific Steps in Nociception Pathway

    • Inhibit perception: anesthetics, opioids, benzodiazepines, phenothiazines.
    • Inhibit transmission: local anesthetics, opioids, alpha-agonists.
    • Inhibit modulation: local anesthetics, opioids, tricyclin antidepressants, cholinesterase inhibitors, NMDA antagonists, NSAIDs, and anticonvulsants.
    • Inhibit transduction: local anesthetics, opioids, NSAIDs, corticosteroids.

    Examples of Multimodal Anagesia

    • Acetaminophen & codeine for moderate-severe pain in dogs.
    • Fentanyl & meloxicam for pain relief in cats.
    • Morphine, Lidocaine, & Ketamine (MLK) for moderate-severe pain in dogs.

    Analgesia Timing

    • Analgesia is important at every stage of hospitalisation (pre-anesthesia, surgical period, immediately postoperative, remainder of stay at home).

    Criteria for Drug Choice

    • Severity and type of pain.
    • Patient's general condition.
    • Route of delivery.

    Signs of Animal Pain

    • Vary depending on species, age, breed, and temperament.
    • Young patients less tolerant.
    • Large breeds of dogs more stoic than small or toy breeds.
    • Cats tend to hide, whereas dogs seek owner comfort, with the herd animals separating themselves.
    • Pain response can vary based on nature, duration, and severity of pain, and presence of humans.
    • Changes in behaviour, posture, facial expressions, and attitude are common.
    • Signs to look for: vocalization (whimpers, growls, etc.), reduced appetite, changes in posture (guarding behaviour, avoiding movement), changes in facial expression/attitude/appearance, difficulty sleeping, depression, changes in gait or motility, reluctance to move, constant shifting of position, decreased grooming.

    Signs of Pain (in general)

    • Decreased appetite, decreased sleeping time, changes in posture, changes in gait (level of activity), and reluctance to lie down.
    • Decreased grooming, poor body condition, significant reductions in activity or motility.
    • Vocalization signs (whining, growling etc.) emergence delirium, immediate postoperative vocalization, changes in facial expressions, and attitude, (crouching, posture alteration, head tilt)
    • Specific examples in different animal types are also mentioned (canine, feline, equine) behaviours.

    Pain in Animals Under Anesthesia

    • Anesthetized animals can process nociception but aren't consciously aware.
    • Signs of pain under general anesthesia include increased heart rate and respiration rate, increased blood pressure, difficulty maintaining plane of anesthesia, trembling, changes in normal behaviour (or lack thereof), changes in normal posture/movement.

    Things to consider

    • When was the last analgesia?
    • Was it adequate?
    • Age of the animal and comorbidities.
    • Severity of pain
    • Surgery duration

    Pain vs Anxiety

    • Pain can be difficult to distinguish from anxiety, as physiological changes similar to anxiety can occur during pain. Observing patient behaviours can assist to distinguish, with pain generally being more acutely reflected, whereas anxiety can be more chronic in nature.

    Consequences of Untreated Pain

    • Sympathetic stimulation (vasoconstriction, increased cardiac work/heart rate, increased oxygen consumption/hypoxia)
    • Immune/inflammation system issues /delayed wound healing or impaired healing)
    • Increased anesthetic risk / increased anesthetic doses required; greater adverse effects of anesthesia/recovery etc.)
    • Patient suffering

    Stress-response Consequences of Untreated Pain

    • Cardiovascular effects (tachycardia, hypertension, arrhythmias)
    • Respiratory effects (atelectasis, hyperventilation/hypoventilation, hypoxia)
    • Gastrointestinal effects (delayed gastric emptying, nausea, ileus)
    • Renal effects (oliguria and urinary retention)
    • Hematological effects (hypercoagulability, thrombosis risk)
    • Psychological effects (anxiety, fear, fatigue, suffering)

    Recall: References - CRI

    • Reference materials: McCurnin's Clinical Textbook & small animal ECC textbook.
    • Specific chapters and pages are cited to indicate the location of references

    Calculating Constant Rate Infusion

    • Detailed steps for calculating CRI dosages, covering different units (mg/kg/hr vs mcg/kg/min) with specific examples.

    Pain Assessment, Different Species

    • Detailed descriptions of pain assessment techniques for equine, feline, canine, and ruminants.
    • Common behaviours to look out for in each animal type (eg lameness, changes to posture, vocalization, hiding, aggression, stress response)

    Non-Pharmacological Interventions

    • Differentiating pain from other stress-related behaviours.
    • Assessing physical and emotional needs
    • Provide physical comfort or distraction methods to alleviate perceived stress/anxiety.
    • Reassessing patient comfort after addressing emotional and physical pain needs

    Analgesic Options: Non-Pharmacological

    • General nursing care, including cleanliness and padding.
    • Acupuncture
    • Laser analgesics
    • Physical therapies (massage), ice/cold therapy

    Summary of AAHA Pain Management Standards

    • Pain assessment is essential for every patient, especially preemptively.
    • Recording pain assessments in medical records.
    • Employing preemptive pain relief measures.
    • Appropriate pain management for surgical procedures and chronic pain.
    • Using written protocols and teaching client to recognize pain.

    Remember Pain Management

    • Each patient is unique
    • Pain can be well-hidden, with many factors contributing to this including stress and anxiety
    • The procedure itself can profoundly influence perception of pain & therefore requirements for pain management.

    Monitoring Drug Effects

    • Careful monitoring of cardiovascular & mental health in patients is critical when assessing effects of pain relief medicines.
    • Assess for detrimental side effects, or complications and/or further stress factors, and treat these adverse consequences as needed.

    Dysphoria vs Anxiety

    • Dysphoria: A state of uncontrolled unpleasant thoughts and feelings (often induced by drugs).
    • Anxiety: Feeling of worry, nervousness, or unease.
    • Distinction is important because treatments differ

    Overview of Analgesic Categories

    • Opioids, NSAIDs, locals, alpha-2 agonists, NMDA antagonists, and gabapentin are all presented.

    Analgesic: Opioids

    • Mainstay for perioperative pain, highly effective, minimal side-effects, and generally inexpensive.
    • Act on opioid receptors (mu, kappa, delta) within various sections of the body (transduction, modulation, and perception).
    • Different forms of opioid action are provided (eg. mu agonists).

    Analgesic: NSAIDS

    • Act by blocking COX-1 and COX-2 enzymes.
    • Anti-inflammatory and antipyretic.

    Analgesic: Local Anesthetics

    • Block Na-gated channels, preventing action potential propagation in nerve fibers
    • Extremely effective but generally short-acting.

    Analgesic: Topical Anesthesia

    • Applied to surface skin or mucosa to reduce pain.
    • Effective for minor procedures such as wound surgery, venipuncture, arterial punctures, and nasal cannulation.

    Analgesic: Alpha-2 Agonists

    • Decrease NE release peripherally and centrally.
    • Provide potent analgesia in horses, less effective in other species.

    Analgesic: NMDA Antagonists

    • Block glutamate receptors, helping reduce central sensitization
    • E.g., Ketamine (dissociative agent).

    Analgesic: Gabapentin

    • Analgesic adjunct.
    • Used primarily for neuropathic and chronic pain.
    • Helps to prevent/decrease central sensitization (preemptively or before surgery).
    • May have mild sedative properties, especially in cats.

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    This quiz examines the various physiological and psychological effects of untreated pain. Participants will explore the consequences of pain on the immune, cardiovascular, and renal systems, as well as psychological impacts and assessment tools. Test your knowledge on this critical aspect of pain management.

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