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Veterinary Nursing Anaesthesia and Analgesia > Pain Management > Flashcards

Flashcards in Pain Management Deck (50)
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1

What is pain?

- Sensory experience associated with tissue damage
- Emotional component in humans and animals

2

Forms of pain management? (3)

- Analgesia
- Multi-modal analgesia
- Pain scoring methods (pain behaviour)

3

Why should pain be avoided? (Mention 4 things)

- 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!

4

Name 3 responses to pain

- 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

5

What is acute pain associated with?

Injury / trauma
- may be post surgical

6

When does acute pain usually abate

- as healing occurs

7

What is acute pain?

Pain that does not usually outlast the initial painful stimulus

8

What is chronic pain?

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

9

What can chronic pain cause changes in

-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

10

What is pre-emptive analgesia

Administration of analgesics prior to pain stimulation preventing neuron sensitisation

11

What are the three kinds of pain?

- Physiological
- Inflammatory
- Neuropathic

12

What is physiological pain?

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

13

What is inflammatory pain?

Clinical pain
- caused by surgery?
inflammation

14

What is neuropathic pain?

Caused by direct damage to the nervous system

15

What is the physiology of pain

- 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

16

What can repeated stimulus of pain pathways cause?

Heightened sensitivity

17

What are nerve endings that detect painful stimuli called?

Nociceptors

18

What are the main inflammatory mediators?

Prostaglandins

19

What is transduction

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

20

What are the pain fibres?

Að and C

21

What is the aim of analgesia?

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

22

What can ongoing pain cause?

Chronic hypersensitivity to pain that can outlast the actual pain event

23

What is Allodynia?

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

24

What is hyperalgesia

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