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Anaesthesia & Analge

WK 11

QuestionAnswer
When do we give analgesia preferably when it hurts - pre emptive analgesia not always possible, need to get analgesia on board ASAP pain score but if in doubt - give analgesia
NSAIDS COX-1 = always active maintain homeostasis - especially in the stomach and kidney
NSAIDS COX-2 = Active during injury, stress and trauma
NSAIDS example metacam
Paracetamol no idea how it works - toxic to cats
opioids Mu - µ Kappa – κ Delta - δ
Opioids – Side effects Nausea/vomiting Dysphoria Hypothermia/hyperthermia Hypoventilation/hyperventilation Bradycardia Histamine release Constipation
Potency – this is the amount of drug needed to produce an effect, such as pain relief
Efficacy - this is the potential maximum therapeutic response a drug can produce full/partial agonist antagonist
Opioids - full agonists morphine methadone fentanyl
Opioids - partial agonists buprenorphine
opioids - agonist - antagonist butorphanol
Opioids - antagonists Naloxone
transdermal patches fentanyl buprenorphine
Alpha-2 Agonists Medetomidine Dexmedetomidine
local anaesthesia binds to Na+ channels prevents passage of Na+ this prevents membrane depolarisation prevents transmission of impulse side effects
local anaesthesia topical infiltration regional epidural
types of local anaesthesia lidocaine bupivacaine
ketamine NMDA Antagonist Dissociative anaesthetic
Other drugs that can provide analgesia Magnesium Gabapentin Maropitant Galliprant
Constant Rate Infusion (CRI) multimodal analgesia dont get peaks and troughs
benefits of CRIs ↓ inhalational agents ↓ cardio-respiratory depression Multimodal analgesia Continued into recovery Can titrate doses and wean
Total Intravenous Anaesthesia (TIVA) Drugs that can be used for TIVA: Propofol Alfaxan Opioids – Fentanyl Alpha-2 Lidocaine – DOGS ONLY Ketamine
Vasopressors and Inotropes Hypotension is a common anaesthetic complication Mean Arterial Pressure (MAP) < 60mmHg Systolic Blood Pressure < 80mmHg Delivered as CRI
Receptors Alpha – 1: In the vessel walls, Vasoconstriction Beta – 1: In the heart, increases HR and Contractility Beta – 2: In vessel walls, smooth muscle relaxation, Vasodilation Dopamine: Splenic/renal dilation (not clinically relevant unless high doses)
Created by: lucy.fox
 

 



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