Anesthesiology & Pain Management

Anesthesia should be thought of as 4 distinct and equally important periods: 1) preparation/premedication; 2) induction; 3) maintenance and 4) recovery. We tend to diminish the importance of the phases of preparation/premedication and recovery and yet these phases contribute as much to successful anesthesia as the phases of induction and maintenance.

Because the airway extends from the oral or nasal cavity to the alveoli, respiratory compromise has numerous manifestations. Complications can be encountered in both the upper and lower airways.

The most effective way to deal with anesthetic emergencies is to prevent them and appropriate 1) stabilization of the patient, 2) selection of type and dosage of anesthetic drugs, 3) preparation of anesthetic equipment, 4) pre-, post- and intra-operative support of the patient, and 4) physiologic monitoring, will make the anesthetic episode safer and will decrease the likelihood of anesthetic emergencies.

Regional or local anesthesia of the equine head greatly facilitates performing standing procedures that are anticipated to elicit pain in the patient. With effective local anesthesia, less systemic sedatives may be required for standing surgeries (e.g. dental extractions, laceration repairs, incisor avulsion repairs), patients under general anesthesia can be run at a lighter plane of anesthesia, and postoperative pain may be lessened if effective preemptive analgesia is in place.

Watch how Dr. Tim Crowe uses these three innovative tools in his critical care patients.

Can you spot the subtle signs of postoperative pain in cats?

Topical ophthalmic proparacaine can also be applied to small wounds for quick pain control.

With this pain management modality, promoting healing and your bottom line is a zap.

How you can help alleviate the pain for pets with cancer.

Treating pain is a fundamental part of practicing good medicine.

This anesthetic agent can improve patient experience, boost client compliance.

When anesthetizing a pot-bellied pig, we use a mask made from a plastic gallon jug.

Montreal -- A new study of mouse grimaces could lead to more refined pain measurements for humans and animals.

Drs. James Gaynor and Philip (Pete) VanVranken discuss treating pain associated with various conditions.

To make anesthesia masks hands-free, I create two small holes nearly opposite each other on the clear plastic mask.

Technicians: To truly keep anesthetized patients safe, you must use your hands.

The overall goal of anesthesia is survival and optimum recovery from surgery. In order to accomplish this goal, the surgery patient must be continually monitored for changes, especially deterioration in respiration, cardiac function and tissue perfusion regardless of the specific surgery.

Pain management in veterinary medicine was practically unheard of twenty years ago, and it has advanced dramatically over the past decade. Not only is the physiology of pain and its effects becoming better understood, pain management is considered a vital part of most treatment plans.

Monitoring anesthetized patients is imperative for all procedures. All anesthetic drugs act as cardiovascular and respiratory depressants on varying levels, and they can compromise a patient's homeostasis at unpredictable times in unpredictable ways. Crises are rapid in onset and devastating in nature.

Critical patients and patients undergoing prolonged and invasive procedures may need more intensive monitoring due to their increased risk for anesthetic complications. Some of these methods of monitoring may become more common in the near future considering veterinary anesthesia has advanced dramatically over the past decade.

All anesthetic drugs act as cardiovascular and respiratory depressants on varying levels, and they can compromise a patient's homeostasis at unpredictable times in unpredictable ways. A patient must maintain adequate blood pressure for the duration of any surgical procedure because prolonged anesthetic hypotension can have devastating effects such as renal failure or brain damage.

CRI stands for continuous rate infusion, and its use is becoming more prevalent in the veterinary field as a method to control intraoperative and postoperative pain. It was not long ago that the best options for surgical pain management were intramuscular or bolus injections of opioids, which remain acceptable options, but CRIs can be a better option for patients undergoing prolonged, invasive or painful procedures.

Anesthesia is concerning for every patient, this is especially so when the patient has pre-existing conditions. The value of a thorough physical examination and detailed history cannot be underestimated as part of a balanced anesthetic plan because the goal of the plan is to maximize its' effects while minimizing patient complications.

Patients vary and accidents occur. This truth emphasizes the need for patient monitoring. One only need visit the exhibit hall of a major veterinary meeting to appreciate the advancements made in veterinary patient monitoring.

Anesthetic related mortality would appear to be an easily quantifiable statistic that could be used to measure the outcome of the profession's current anesthetic practices. However, to rely solely on death rate as the measure of the quality of anesthetic care provided is inadequate.

Patients are typically sedated or anesthetized and placed in sternal or lateral recumbency. Next, the cranial edge of the wings of the ilia are palpated.

Pulse oximeters are relatively inexpensive and provide continuous information about pulse rate and hemoglobin saturation. Pulse oximetry has limitations that need to be understood by the anesthetist.

Accurate measurement of pain perception in individual non-human patients is impossible. However, management of pain requires objective measures of effectiveness of the applied treatment.

Patient stress is probably a contributing factor in some cases of adverse patient outcome. Stress during induction of anesthesia can increase circulating catecholamine concentration predisposing the heart to arrhythmias.

In the past blood gas analysis and interpretation was performed primarily at university and large referral hospitals. The main argument against not using blood gas analysis to guide case management in private practice was the cost of purchasing and maintaining a bench-top blood gas analyzer. With the availability of relatively inexpensive point of care units such as the i-STAT and IRMA, blood gas analysis and interpretation has become more common.