Seminars in veterinary medicine and surgery (small animal)
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The drugs most often used for pain relief in animals are the nonsteroidal antiinflammatory drugs (NSAIDS) and the opioid analgesics. The NSAIDS are effective, inexpensive, and long-acting drugs, but their degree of analgesia is limited by the adverse effects at high doses. The most common adverse effect from NSAIDS is gastritis and gastrointestinal hemorrhage and ulceration. ⋯ An important disadvantage of opioids is their short duration and low oral absorption, which necessitates a frequent injection or i.v. infusion for most patients. Recent studies have established other applications for administration of opioids such as a transdermal fentanyl patch. These applications offer new possibilities for convenient administration.
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Semin. Vet. Med. Surg. Small Anim. · May 1997
ReviewManagement of pain in the critically ill patient.
In spite of growing evidence that effective pain management of critically ill human beings decreases their morbidity and mortality, pain is often undertreated in critically ill animals. Reasons for withholding analgesics in these animals have included fear of contributing to cardiopulmonary instability and difficulty in monitoring response to therapy. ⋯ Opioids are the most widely used analgesics but other options exist. Newer methods of analgesic administration include continuous infusions, epidural, local, regional, and transdermal administration.
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Effective treatment of acute pain secondary to surgery and trauma is often a complex and perplexing task. Concern about potential adverse effects of analgesic drugs on cardiovascular, respiratory, renal, and central nervous system functions often limits the use of analgesics in the very patients that could benefit from them the most. ⋯ Similarly, the use of a balanced or multimodal approach to the treatment of acute pain can greatly enhance the clinician's ability to safely provide effective analgesia. Systemic opioids, alpha-2 agonists, nonsteroidal antiinflammatory drugs, and local or regional analgesic techniques can be used in varying combinations to meet the needs of the painful animal and hasten recovery.
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Many benefits can be obtained from the use of drugs applied locally or regionally when treating dogs and cats that are in pain or will be in pain because of surgical trauma. These techniques often use less medication than for systemic administration with a reduction in the likelihood of toxic effects from these compounds. ⋯ Other drugs, such as the opioids, may decrease the nociceptive input with minimal effect on motor activity. This report discusses the use of local anesthetics and other drugs for analgesia of the skin, mucous membranes, joints, pleura, and peritoneum, and the application of these drugs for regional blocks of peripheral nerves and epidural/intrathecal injection.