Term
| What are the 4 neuromuscular blockers? |
|
Definition
Succinylcholine (depolarizing)
Gallamine (non-depolarizing)
Pancuronium bromide
Curare |
|
|
Term
| How do depolarizing muscle paralyzers work? |
|
Definition
| They replace acetylcholine at receptors and prevent receptor activation |
|
|
Term
| How do non-depolarizing muscle paralyzers work? |
|
Definition
| They compete with acetylcholine at receptor sites |
|
|
Term
| What is the reversing agent for non-depolarizing muscle paralyzers? |
|
Definition
| Neostigmine (pretreat with atropine) |
|
|
Term
| What are the effects of succinylcholine? |
|
Definition
Muscle twitching, followed by paralysis
Fast onset, short duration
No reversing agent - must wear off |
|
|
Term
| What are the effects of neuromuscular blockers? |
|
Definition
paralyze only skeletal muscles, not visceral smooth muscle
*cannot move, cannot breathe, but heart & GI muscles can function |
|
|
Term
| Do neuromuscular blockers affect the CNS? |
|
Definition
| No effect on CNS, no analgesia, no sedation |
|
|
Term
| What are the precautions you must take when using neuromuscular blockers? |
|
Definition
1. Administer after induction of general anesthesia
2. Must intubate patient and ventilate
3. Monitor for hypothermia
4. Lubricate eyes |
|
|
Term
| What are the types of local anesthesia? |
|
Definition
1. Topical
2. Infiltration
3. Nerve blocks
4. Line or ring blocks
5. Intra-articular
6. Regional anesthesia
7. Epidural |
|
|
Term
| What are the application methods for topical local anesthesia? |
|
Definition
* skin
* eyes
* mucous membranes |
|
|
Term
| What are the application methods for infiltration local anesthesia? |
|
Definition
| Drug injected SQ around site - diffuses to site |
|
|
Term
| What is infiltration used for? |
|
Definition
Used for wounds, small skin cysts, tumors, warts
ex: intratesticular blocks |
|
|
Term
| What are the application methods for nerve blocks? |
|
Definition
| Drug injected near (not into) specific nerve; blocks sensation from area distal to injection site |
|
|
Term
| What are nerve blocks used for? |
|
Definition
Used for lameness exams in horses, cattle
Used for bovine dehorning, eye surgery, feline declaws |
|
|
Term
| What are the application methods for line or ring blocks? |
|
Definition
| Continuous line or ring of drug injected proximal to body part |
|
|
Term
| what are line or ring blocks used for? |
|
Definition
| Feline declaws, bovine teat, digit surgery |
|
|
Term
| What are the application methods for intra-articular anesthesia? |
|
Definition
| Drug injected into a joint |
|
|
Term
| what is intra-articular anesthesia used for? |
|
Definition
| used for post-surgical pain management |
|
|
Term
| What are the application methods for regional anesthesia? |
|
Definition
| Drug injected where major nerves exit spinal cord |
|
|
Term
| What is regional anesthesia used for? |
|
Definition
Used often in large animal medicine
used for analgesia of entire limb, caudal trunk |
|
|
Term
| What are the application methods for epidurals? |
|
Definition
Drug placed into epidural space, between dura mater and interior surface of vertebral canal
Administered dorsally through lumbosacral space |
|
|
Term
| How does an epidural work? |
|
Definition
| Blocks sensation & motor control caudal to injection site |
|
|
Term
| What are some uses of an epidural? |
|
Definition
Large animal obstetrics and vaginal prolapses
Small animal C-sections
Profound postsurgical pain management |
|
|
Term
| What are some precautions to consider with epidurals? |
|
Definition
Requires ventral recumbency, sedation
Requires surgical clip & prep
Elevate head to prevent drug traveling forward |
|
|
Term
| What are some precautions to consider with infiltration? |
|
Definition
| May cause inflammation, swelling, delayed wound healing - dose should be limited |
|
|
Term
| What are some precautions to consider with any local anesthetic? |
|
Definition
Injection into a nerve may cause temporary neuritis or permanent nerve damage
If drug reaches brain in high concentration - seizures, death
*Aspirate before injection to prevent IV administration
*Elevate head for epidurals
Injections by any route require clip, prep |
|
|
Term
|
Definition
| One drug increases the effectiveness of another drug |
|
|
Term
| What purpose does epinephrine serve in local anesthesia? |
|
Definition
| Potentiates local anesthetics by causing peripheral vasoconstriction; delays absorption of drug; drug stays in site longer |
|
|
Term
| List the local anesthetics |
|
Definition
Lidocaine
Bupivicaine
Mepivicaine
Procaine
Proparacaine |
|
|
Term
| What is lidocaine used for? |
|
Definition
Local anesthetic:
most common, immediate onset, lasts 1-2 hours |
|
|
Term
| What is bupivicaine used for? |
|
Definition
Local anesthetic:
common, slower onset, longer duration 6-12 hours |
|
|
Term
| What is mepivicaine used for? |
|
Definition
Local anesthetic:
used in horses, less tissue reaction |
|
|
Term
| What is procaine used for? |
|
Definition
Local anesthetic:
may be used in bovines |
|
|
Term
| What is proparacaine used for? |
|
Definition
Local anesthetic:
ophthalmic topical |
|
|
Term
| How do local anesthetics work? |
|
Definition
Prevent sensory nerve transmission at axon by interfering with sodium pump. May also affect voluntary motor control of body part.
No effect on brain when properly administered / dosed |
|
|
Term
| List some reasons why we treat pain |
|
Definition
1. Procedures painful in humans considered to be painful in animals
2. Owners concerned about pain in pets
3. New general anesthetics => rapid recovery, with little or no postoperative sedation or analgesia
4. Decreased movement due to pain no longer seen as protective
5. Human studies show survival rates and recovery times improve with effective pain management
6. pain management is a fundamental part of patient care |
|
|
Term
| What are the goals of pain management? |
|
Definition
1. Allow patient to move, eat and sleep without undue discomfort
2. Focused on first 1-3 days after routine surgery
3. Longer if severe trauma or especially painful surgery |
|
|
Term
|
Definition
| Sensory nerve cells in skin or deep tissues that can detect a noxious stimulus and convert it to nerve impulses |
|
|
Term
|
Definition
| Heat, ischemia, distention/stretching; mechanical injury; chemicals released by inflammation or tissue injury |
|
|
Term
| How are impulses transmitted? |
|
Definition
| sensory neuron in tissue => spinal cord neuron => brain neuron (where pain is perceived) |
|
|
Term
|
Definition
Myelinated nerve axons
*sharp, discrete pain
*fast transmission
*patient can localize the site easily |
|
|
Term
|
Definition
Nonmyelinated nerve axons
*dull, aching or throbbing pain
*slow transmission
*patient cannot easily pinpoint source |
|
|
Term
|
Definition
Somatic pain involves:
skin, SQ, muscles, bones, joints
both A delta and C fibers are involved |
|
|
Term
|
Definition
Involves internal organs
primarily C fibers only |
|
|
Term
|
Definition
| unpleasant sensory and emotional experience associated with actual or potential tissue damage |
|
|
Term
|
Definition
|
|
Term
|
Definition
acute vs chronic
acute pain more responsive to analgesics than chronic pain |
|
|
Term
|
Definition
| Normal response to tissue damage |
|
|
Term
|
Definition
| changes in the CNS from chronic, unmanaged pain that causes the CNS to be more, rather than less, sensitive |
|
|
Term
|
Definition
| Pain from a stimulus that does not normally cause pain |
|
|
Term
|
Definition
| increased sensitivity to a stimulus that is normally painful |
|
|
Term
|
Definition
| felt in a body part other than the cause (ex: angina in human heart attack patients) |
|
|
Term
|
Definition
| due to direct damage to peripheral nerves or spinal cord. often poorly responsive to analgesics |
|
|
Term
|
Definition
When spinal nerves are repeatedly subjected to high intensity nociceptive impulses, they become progressively and increasingly excitable, even after stimulus is removed.
This leads to hyperesthesia which leads to allodynia
This leads to maladaptive pain |
|
|
Term
| What are some indicators of pain? |
|
Definition
*decreased activity
*restlessness - unable to get comfortable
*limping, guarding a body part
*increased heart rate
*increased respiratory rate
*abnormal body posture
*dilation of pupils(may also be due to drugs)
*depression
*inappetance
*vocalization
*trembling, shaking
*inability to sleep
*licking or chewing |
|
|
Term
| What is pre-emptive analgesia |
|
Definition
Timing of administration of analgesics is critical.
Pre-emptive administration is more beneficial than giving the same amount post-operatively
Decreases the amount of general anesthesia needed |
|
|
