pain management

Re: pain management

hollye4532 — Wed, 08 Jun 2011 23:03:52 GMT

thanks for the tips guys.

Re: pain management

Nick Shackleton — Wed, 08 Jun 2011 18:33:04 GMT

As phrin has stated at the end of the day it is the vets choice as to what drugs to use (although nurses are taught about pain relief and how the different drugs work).

Have you thought about doing pain scoring and regular TPR on your patients. Both these can flag up indications that the patient is painful. Such as increased resp rate. Glasgow uni have a really easy to use pain score.

I find that just looking at the patient and deciding whether it is painful or not very accurate and peoples perceptions are completely different.

here is a link to the pain score http://www.gla.ac.uk/departments/painandwelfareresearchgroup/downloadacutepainquestionnaire/

For all procedure pre-emptive (before pain caused) analgesia and multi-module (different drug classes) should both be used to stop pain pathways.

There are so many different drug combinations that can be used. It is hard to discuss in full. Maybe it would be a good idea to go on an anaesthesia CPD as Analgesia is a key part of balanced anaesthesia.

Re: pain management

Phrin Vernon RVN — Tue, 07 Jun 2011 23:51:48 GMT

Ah but that was that memorable occasion, with a kiwi vet, who I love dearly!

Our first ops day together he down right refused to give a cat cast any pain relief... I had the metacam inj hovering over the cats scruff..

I can remember to this day, looking him square in the eye, and saying ' OK, but if your balls had just been cut off would you want some pain relief?'

Bless him (such an ace man) - he laughed & laughed , and said, 'Yes, oh go on then!!'

That was when he was new to the practice - he got well trained

Re: pain management

Phrin Vernon RVN — Tue, 07 Jun 2011 23:42:09 GMT

Its always difficult because at the end of the day, the decision to give analgesics lays with the VS

In my last practice, which was mixed, I was very keen on looking for any signs of pain post op, and nine times out of ten, once pointed out to the busy vet they would agree that more analgesia was needed, and would OK us to give it.

Can't really comment on ortho ops as it has been years since I was involved with them in referral practice, but the vet at that last refferal practice was sh*t hot on pain relief, used fenanyl patches, morphine etc, but had 24 hrs nursing at his disposal.

At my last practice (mixed), used to do a few cruciates and patient usually got an extra shot of vetergesic on discharge with metacam at home & a four week course of cartrophen.

As a nurse, there have been countless times where I have noted an animal in pain and mentioned this to the VS for them to agree and prescribe pain relief - That is part of our job no?

I think our vets were pretty much 100% relient on VNs to point out pain, discomfort, change in demeanour etc, as we should do.

I have always (mostly) been lucky that the vets listened to me, assessed the patient, and usually gave analgesia!