Katy W. Waddell, RVT, VTS (ECC, anesthesia)

Systemic administration of analgesic agents is the most common route of delivery during the perioperative period. These routes would include delivery by transdermal, subcutaneous, intramuscular, intra-articular and intravenous. Intravenous administration of analgesic agents may be timed to be given intermittently or by constant rate infusion.

What is pain? Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. All potential and actual tissue damage in animals should be considered to cause pain. Pain can be experienced with or without accompanying signs of stress (e.g., tachycardia, hypertension). The first step in treating pain is to recognize the signs and symptoms.

Anesthetizing a patient with cardiac disease requires a plan for the use of supportive measures to maintain adequate tissue perfusion. As in the case of left sided cardiac dysfunction patients, volume administration frequently is not an option to support blood pressure. In these cases, should a positive inotropic or pressor agent be indicated, the volume of the adjunctive agent required should be deducted from the volume of crystalloid administered to maintain a balanced hourly rate.

What is pain? Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. All potential and actual tissue damage in animals should be considered to cause pain. Pain can be experienced with or without accompanying signs of stress (e.g., tachycardia, hypertension). The first step in treating pain is to recognize the signs and symptoms.

Capnographs are used to measure ETCO2. Most capnographs use infrared light absorption to measure CO2 levels. Capnographs allow for continuous monitoring of the patients CO2 levels. ETCO2 is reflective of the patients PaCO2 usually within a 5mmHg gradient, this gradient can be affected by pulmonary perfusion.

As with any trauma patient presented to triage, a thorough pre-operative assessment must be performed and patient assessment begins with the first step inside the door. The traumatized patient will have altered physiological responses that will in turn alter the pharmacokinetics of the agents commonly used to provide anesthesia.