Anesthesiology & Pain Management

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.

The electrocardiogram is a useful monitoring tool, but its proper use requires training. It provides a heart rate and a picture of the electrical activity of the heart muscle. The anesthetist should be trained to recognize many commonly encountered intraoperative arrhythmias (e.g., multifocal and unifocal ventricular premature complexes, atrioventricular blockade, ventricular tachycardia, etc.) and the veterinarian should be prepared to treat arrhythmias when they occur (if necessary).

Anesthetic and pain 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.

Alpha 2 adrenergic agonists bind to alpha 2 receptors located in the dorsal horn of the spinal cord and brainstem, modulating the release of substance P, calcitonin gene-related peptide and various other neurotransmitters involved in rostral transmission of nociceptive information.

Clients frequently express concern about the anesthesia their dogs or cats need for professional oral evaluation and care.

For our local anesthetic blocks, we use a combination of lidocaine (quick onset, short duration) and bupivacaine (slow onset, long duration) with or without buprenorphine (acts at peripheral opioid receptors).

Two team members sound off about the recent California declaw bans.

Put yourself in others' shoes, paws, hooves or claws

Dr. Robin Downing has built a comprehensive osteoarthritis pain management system that uses a combination of modalities.

Certain cases of cancer may respond well to conservative analgesic therapy initially but eventually require multimodal analgesia.

A Q&A with veterinary anesthesiologist Dr. Kurt Grimm

Dr. Robin Downing discusses the advancement of pain management in animals.

This on-demand AVMA course by Dr. Nora S. Matthews provides an overview on achieving analgesia and balanced anesthesia and also reviews common complications and their treatment. (1 CE credit)

This on-demand AVMA course by Dr. Daniel M. Weary reviews some of the recent research on pain assessment and detection in cattle. (1 CE credit)

This on-demand AVMA course by Dr. Jacqueline R. Davidson identifies some factors that must be considered when designing a rehabilitation program for an animal following surgery. (1 CE credit)

Osteoarthritis and cervical pain can present with clinical. Almost all skeletal preparations of horses over 18 years old have evidence of arthritic changes.

Managing postoperative pain should rank as a top concern for team members and pet owners. Follow these position-specific guidelines to educate clients and help keep their pets comfortable.

Many of our patients in veterinary dentistry are older or have compromised core body functions.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely used analgesic drug class in human and veterinary medicine.

Opioids provide both analgesia and sedation.

There are four main goals for anesthesia in the ophthalmic patient.

There are a variety of options for providing analgesia to veterinary patients in the peri-anesthetic period.

The respiratory system is one of the most important physiologic systems that the anesthetist can affect during an anesthetic event.