Analgesia (start with Neuromuscular)

Discussion Question

Open Ended

Can we give a neuromuscular blocking agent to an awake patient?

Why or why not?

Question:

Open Ended

What is pain?

Review!

Match

Match the following.

• Pain of immediate onset after injury. Resolves when healing complete.

• Detection by the nervous system of the potential for or actual tissue injury.

• Long-lasting pain that persists beyond the normal healing time

• Pain that occurs after tissue injury.

• Protective sensation of pain "Ouch!"

Acute Pain

Nociception

Chronic Pain

Pathologic Pain

Physiologic Pain

• Acute Pain

• Nociception

• Chronic Pain

• Pathologic Pain

• Physiologic Pain

Review!

Match

Pathologic Pain
Match the following

• Pain originating from injury to the skin.

• Nerve injury.

• No identifiable cause for pain.

• Pain originating from organs.

• Pain originating from the musculoskeletal system.

Superficial

Neuropathic

Idiopathic

Visceral

Somatic

• Superficial

• Neuropathic

• Idiopathic

• Visceral

• Somatic

Review!

Reorder

Put the steps of the Pain Pathway in order.

• Transduction

• Transmission

• Modulation

• Perception

1

2

3

4

• 1
• 2
• 3
• 4

Review!

Multiple Choice

What happens to a dog's muscles when their pain is not treated?

• Muscle atrophy and weakness in dogs.

• Untreated pain leads to enhanced muscle growth.
• Dogs experience improved flexibility when in pain.
• Muscle strength increases with untreated pain.

Multiple Choice

What happens to a cat's immune system when their pain is not treated?

• A cat's immune system becomes stronger, reducing the risk of infections.
• A cat's immune system remains unchanged, unaffected by pain.
• A cat's immune system becomes suppressed, increasing susceptibility to infections.
• A cat's immune system overreacts, causing autoimmune issues.

Multiple Choice

What are consequences of untreated pain in our veterinary patients?

• Improved social interactions, enhanced mobility and activity levels

• Increased appetite and weight gain

• Decreased quality of life, impaired healing, and increased stress.

Review!

Match

Match the following veterinary terms

• Central nervous system hypersensitivity.

• Area close to site of tissue injury becomes painful to even normal stimulus.

• Detection by the nervous system of the potential for or actual tissue injury.

• Metabolism breaking down tissues faster than they can be replaced or repairs.

Windup

Primary Hyperalgesia

Nociception

Catabolic State

• Windup

• Primary Hyperalgesia

• Nociception

• Catabolic State

Review!

Multiple Choice

What should we do to prevent "windup" pain in our veterinary patients?

• Increase the patient's activity level

• Use sedatives like midazolam

• Start pain control before painful procedure

• Force-feed patients to prevent catabolic state.

Question:

Open Ended

Can you name the 5 freedoms?

Review:

Categorize

Options (19)

Mydriasis

Vocalizations such as whining, groaning, growling

Exaggerated abdominal breathing

Purring

Cat with ungroomed appearance

Grinding teeth (large animals)

Furrowed brow in cats

Pointing limbs in horses

Arched back in cows

Hypertension

Tachypnea

Tachycardia

Open-mouth breathing

Hypotension

Bradycardia

Reluctance to move or jump

Dog that wanders and will not lay down

Aggression

Drinking water

Categorize the following.

Physiologic Signs of Pain

Behavioural Signs of Pain

Not a sign of pain

Feline Grimace Scale - pain in cats

Multiple Choice

Which of of these cats would you consider is showing marked signs of pain?

Multiple Choice

Identify the painful cat.

Multiple Choice

Identify the painful cat

Multiple Choice

A little review before a break:

Multiple Select

Which 2 cats are experiencing pain?

Match

Match the following.

• Pain of immediate onset after injury. Resolves when healing complete.

• Detection by the nervous system of the potential for or actual tissue injury.

• Long-lasting pain that persists beyond the normal healing time

• Pain that occurs after tissue injury.

• Protective sensation of pain "Ouch!"

Acute Pain

Nociception

Chronic Pain

Pathologic Pain

Physiologic Pain

• Acute Pain

• Nociception

• Chronic Pain

• Pathologic Pain

• Physiologic Pain

Match

Pathologic Pain
Match the following

• Pain originating from injury to the skin.

• Nerve injury.

• No identifiable cause for pain.

• Pain originating from organs.

• Pain originating from the musculoskeletal system.

Superficial

Neuropathic

Idiopathic

Visceral

Somatic

• Superficial

• Neuropathic

• Idiopathic

• Visceral

• Somatic

Reorder

Put the steps of the Pain Pathway in order.

• Transduction

• Transmission

• Modulation

• Perception

1

2

3

4

• 1
• 2
• 3
• 4

Multiple Choice

What are consequences of untreated pain in our veterinary patients?

• Improved social interactions, enhanced mobility and activity levels

• Increased appetite and weight gain

• Decreased quality of life, impaired healing, and increased stress.

Match

Match the following veterinary terms

• Central nervous system hypersensitivity.

• Area close to site of tissue injury becomes painful to even normal stimulus.

• Detection by the nervous system of the potential for or actual tissue injury.

• Metabolism breaking down tissues faster than they can be replaced or repairs.

Windup

Primary Hyperalgesia

Nociception

Catabolic State

• Windup

• Primary Hyperalgesia

• Nociception

• Catabolic State

Categorize

Options (19)

Mydriasis

Vocalizations such as whining, groaning, growling

Exaggerated abdominal breathing

Purring

Cat with ungroomed appearance

Grinding teeth (large animals)

Furrowed brow in cats

Pointing limbs in horses

Arched back in cows

Hypertension

Tachypnea

Tachycardia

Open-mouth breathing

Hypotension

Bradycardia

Reluctance to move or jump

Dog that wanders and will not lay down

Aggression

Drinking water

Categorize the following.

Physiologic Signs of Pain

Behavioural Signs of Pain

Not a sign of pain

Draw

We will take a little break before covering Opioids.
If you wish, you can colour this cat in the meantime :)