Poorly controlled pain causes prolonged healing and hospitalisation times, increased patient anxiety and can precipitate the development of chronic pain. Effective analgesia is increasingly seen as vital not only for animal welfare but also for successful procedural outcomes.
“Complex processes occur throughout the body when painful events occur,” says Jurox Technical Services veterinarian Dr Karen Kerr. “Understanding these allows veterinarians to use analgesic medications to disrupt this pathway and minimise both the unpleasant sensations and harmful, sometimes permanent, physiological changes associated with pain.”
Tailored yet flexible analgesic planning, rather than a ‘one size fits all’ approach, improves animal comfort, recovery and owner satisfaction. The degree of pain from a particular procedure, the individual animal’s temperament, breed and any pre-existing conditions, along with the intricacies of analgesics used, all impact our patients’ experience of pain.
Pain management can be optimised with multi-modal analgesia, where medications with different modes of action are used to target various sites involved in the pathway. This also allows the analgesic benefits of each drug to be gained while limiting the potential for adverse effects. Drugs that may be used include opioids, non-steroidal anti-inflammatory drugs (NSAIDs), α2-adrenergic agonists, and local and dissociative anaesthetics. Each of these have advantages and limitations, and developing a solid understanding of their use for analgesia allows clinicians to use them with confidence.
“One example of how variability can exist within a class of analgesics is the opioid, which we recognise as potent pain relievers,” explains Dr Kerr. “The specific medications vary widely in analgesic and sedative efficacy, potential for side effects and duration of action. For instance, pure µ opioid receptor agonists, such as methadone, morphine and fentanyl, offer strong pain relief of relatively shorter duration while buprenorphine, a partial µ-agonist offers more limited analgesia of longer duration. Butorphanol, an agonist-antagonist, offers minimal analgesia in dogs and cats, but provides short-term sedation, especially when combined with anα2-agonist such as medetomidine.”
“We must remember that pain is dynamic and subjective, meaning the responses of two animals to the same procedure may be quite different,” continues Dr Kerr. “Monitoring and managing pain responses intra-operatively increases the likelihood of a comfortable patient in recovery and can reduce the requirement for rescue analgesia. An assessment of pain should be included in post-operative examinations and it is important to remember that the stated durations of action for analgesic medications are not absolute—in some cases repeat doses or additional medications may be required sooner than expected. Pain scoring protocols can help with keeping the entire hospital team on the same page, and setting specific ‘intervention levels’ removes doubt over when to consider altering treatment plans.”
Like pain itself, what we understand about pain is dynamic. To help vets stay up to date with the latest and best ways to manage pain, Jurox has developed a practical and practice-relevant guide to analgesia. Peri-anaesthetic Analgesia: A guide to current practices is a versatile and varied handbook on a wide variety of drugs and techniques, and is available free with an order of any two products in the Jurox Analgesia Family. Including Bupredyne® (buprenorphine), Methodyne® (methadone), Butordyne® (butorphanol), Reliven® (meloxicam), Medetate® (medetomidine) and Antipam (atipamezole),there is plenty of opportunity for a clinic to secure a guide. Speak to your Jurox Territory Manager to place your order.
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