Question

Veterinary Anesthesia & Surgical Assisting - Analgesics

Identify the different mechanisms or fundamental types of pain.

What are nociceptors? Anatomy review: What is the difference between a nerve and a neuron?

Are nociceptors part of the CNS or PNS? Are they sensory neurons or motor neurons? Efferent or Afferent?

What about nociceptors in the autonomic nervous system?

Define the steps in the physiology of pain- transduction, transmission, modulation, perception. Where does each of these occur?

Describe the difference between primary and secondary hyperalgesia.

What is a common name for secondary hyperalgesia?

Identify 3 adverse effects of pain, in addition to patient suffering.

There are many behavioral and physiology signs that may indicate pain.

Briefly describe signs to look for in each of these categories Mentation & Attitude Facial Expressions Body Posture & Gait Vocalization Physiologic parameters Give 2 examples of a visual analogue scale for measuring pain. This system is widely used to assess pain in people, and is reasonably reliable. Why is it not as effective in veterinary patients?

What terms might be used to describe pain using a verbal/descriptive rating system?

What are the advantages and disadvantages of this type of system?

How does it compare to a simple numeric rating scale (like the pain scale on the SOAP form we use for surgery)?

The Colorado State University Canine and Feline Acute Pain Scales are numeric rating scales.

Why does this system provide more consistent results than the simple numeric rating scale?

The Glasgow Composite Measure Pain Scale is a categorical numeric rating scale.

What makes this type of assessment superior to other types of pain assessment?

What is the major disadvantage to using a system like the Glasgow Pain Scale?

What are the 2 categories of drugs most often used as analgesics in veterinary patients?

Compare the advantages and disadvantage of these categories of drugs (not individual drugs) for treating different types of pain.

What is the origin of opioid drugs? What receptors do these drugs act upon in the body?

Define the terms agonist, partial agonist, agonist-antagonist, and antagonist.

What are the most likely adverse effects of opioids on the respiratory system? The GI system? What other adverse effects do we see, especially in cats and horses? Make a chart comparing these opioid drugs.

What measures should be taken to prevent these adverse effects in patients undergoing anesthesia & surgery?

What is cold laser therapy? What are benefits of cold laser therapy? What is safety precaution for using cold laser therapy?

What is physical therapy? What is goal of physical therapy?

Answer 1

1. Types of pain :-

acute pain

has a rapid onset and short duration, and subsides when the injury is healed (trauma, surgery, labor, acute disease)

cancer (malignant) pain

pain that stems from cancer or cancer treatment (tumor pressing on a bone or nerve, organ obstruction, toxicity from chemotherapy)

non-cancer pain

acute pain that becomes chronic pain and may be prolonged and potentially life threatening (whiplash, low back pain, osteoarthritis, sickle cell disease, neuralgia)

chronic pain

episode of pain that lasts for 6 months or longer; may be intermittent or continuous and may lead to disability (arthritis, fibromyalgia, neuropathy)

neuropathic pain

episodic or continuous pain that results from a nerve injury and persists even without painful stimuli (tumor, infection, toxicity from chemo, neuropathy)

nociceptive pain

physiologic pain that results from nociceptor stimulation in response tho an injury or tissue damage (surgery, inflammation, trauma)

visceral pain

nociceptive or physiologic pain (organs, such as heart, lungs, kidneys, gallbladder)

referred pain

pain in an area other than the area causing the pain (jaw and left arm pain with a myocardial infarction)

radiating pain

pain that extends to other areas (gastroesophageal reflux, extending to the thorax)

somatic pain

nociceptive or physiologic pain (bone, skin, joint, muscle)

2. Nociceptor

Defined as a sensory neuron that responds to potentially damaging sensory stimulation. Can be classified as external (cutaneous nociceptors) or internal (associated with organs, muscles, bladder, and gut). Nociceptors generally have receptors that consist of bare nerve endings.

Difference between nerve and neuron :

Neurons are organized into bundle fibers called nerves.

Nerves arre assigned to specific areas of body which recieve and transmit into nerves and connect nervous system with other systems.

3. Nociceptors are sensory neurons .They are afferent neuron and part of peripheral nervous system .

5. Steps of pain:-

Transduction: tissue damage which is converted to electrophysiologic activity

Transmission: pain impulse moves along A and C fibers into dorsal horn then to brainstem, thalamus, and cortex

Perception: conscious awareness of pain (sensory and cognitive)

Modulation: process of suppressing or facilitating pain