Post Op Analgesia

Re: Post Op Analgesia

jojo69 — Tue, 10 Aug 2010 17:37:35 GMT

What age do you class cats kittens?

I'm interested as i have always given NSAIDs to cat spays pre-operatively and we neuter cats from 5 months?

Re: Post Op Analgesia

Claire Cameron — Mon, 24 May 2010 19:14:12 GMT

[quote user="Nick Shackleton DipAVN(Surgical)VN MBVNA"]Some Vet anaesthetists are not keen on the use of NSAIDs in kitties pre-op due to the drop in blood pressure during anaesthesia causing decreased blood flow to kidneys and possible causing damage to the kidneys........[/quote]

We give our NSAID post op for thsi reason

Re: Post Op Analgesia

Steph Phillips — Sat, 22 May 2010 21:58:19 GMT

We give: acp / buprecare / betamox LA & metacam in our premed.. and Alfaxan as the induction.. never ever had a problem

with females though, we offer metacam cat oral to go home with which they start 48hrs after surgery

Re: Post Op Analgesia

Nick Shackleton — Sat, 22 May 2010 10:20:15 GMT

[quote user="Gillian Mostyn"]

[quote user="Nick 'Batfink' Shackleton DipAVN(Surgical)VN MBVNA"] opiates (and I mean pure antagonist)[/quote]

ah-hem smarty pants - I think you mean pure agonist??

hehehehehehe - couldn't resist!

[/quote]

yeah that too!!! sorry end of a hidious day at work!

Re: Post Op Analgesia

Gillian Mostyn — Sat, 22 May 2010 09:55:17 GMT

[quote user="Nick 'Batfink' Shackleton DipAVN(Surgical)VN MBVNA"] opiates (and I mean pure antagonist)[/quote]

ah-hem smarty pants - I think you mean pure agonist??

hehehehehehe - couldn't resist!

Re: Post Op Analgesia

Siobhan Steven — Sat, 22 May 2010 08:59:15 GMT

And it may be of interest, COX-1 inhibiting NSAID's (e.g Ketoprofen) are more likely to cause platelet inhibition. So administration should be postponed until after surgery to avoid excessive intra operative bleeding.

As far as providing analgesia for cat castrates I always have. We have tailored anaesthetic/analgesic protocols for all patients, but we have everything available to us at the University which means mutli modal analgesia is give on an individual patient basis.

The thing is with Kitties, and their rather badly designed kidneys is, we can be giving them these drugs (NSAID's for example.) and we won't 'have a problem', because the effects will remain underlying until 75% of kidney function is compromissed and then its bye bye kitty, so we should er on the side of caution and give their renal organs the benifit of the doubt.

Sorry to ramble on, but it is a fav area of mine in nursing! (Anaestheic/analgesia)

Re: Post Op Analgesia

Siobhan Steven — Sat, 22 May 2010 08:37:44 GMT

Agree with Nick. I have not worked in a clinic where NSAID's have been administered pre op, due to the hypotensive nature of premeds, induction and maintenance drugs. If the pre med contains a form of analgesia (which it should) = pre emptive, then the NSAID's can be given post op, some say to wait until the patient is up and about, but others, if the BP has been good throughout then at the end of Sx is OK, the premed should remain in effect until the NSAID's kick in. I give a fluid bolus, just draw up some LRS in a syringe and inject into catheter for desexings, all other Sx is on IVF. Also as far as A.B's are concerned they shouldn't be necessary for a quick clean Sx (desexing) unless a hidiously slow new grad is doing it! Good prep, aseptic technique and clean equipment and surgery should make it unecessary.

Re: Post Op Analgesia

SmegSlayer — Sat, 22 May 2010 08:03:15 GMT

[quote user="Phrin SVN"]

[quote user="Nick 'Batfink' Shackleton DipAVN(Surgical)VN MBVNA"]

Some Vet anaesthetists are not keen on the use of NSAIDs in kitties pre-op due to the drop in blood pressure during anaesthesia causing decreased blood flow to kidneys and possible causing damage to the kidneys........

[/quote]

Ohhh - thats our vets reasons for not giving nsaids with the premed

[/quote]

Especially when you use triple combo which really rdecreases perfusion

Re: Post Op Analgesia

Phrin Vernon RVN — Fri, 21 May 2010 22:30:06 GMT

Well we give bup as part of the premed, and nsaids after induction - bup lasts 6hrs ish doesn't it? So plenty of time for the nsaids to kick in?

Unfortunatley we dont have N2O, and the vets very rarely break out the methadone - usually just for the REALLY painful cases!

Re: Post Op Analgesia

Nick Shackleton — Fri, 21 May 2010 22:24:46 GMT

[quote user="Phrin SVN"]

[quote user="Nick 'Batfink' Shackleton DipAVN(Surgical)VN MBVNA"]

[/quote]

Ohhh - thats our vets reasons for not giving nsaids with the premed

[/quote]

Yes but adequate pain relief must be given instead of NSAIDs ie local anaesthetic techniques, Nitrous oxide, Alpha 2s, opiates (and I mean pure antagonist), ketamine etc........

Re: Post Op Analgesia

Vicky RVN — Fri, 21 May 2010 22:18:00 GMT

Oh...will have to remember that. The only time we haven't given it is if doing a procedure that we don't think will need NSAIDs, but then turns out we end up doing something that does, so give it then, either during procedure or after. Will try to keep that info in my head (i swear a lot of what i'm taught swims away again!)

Re: Post Op Analgesia

Phrin Vernon RVN — Fri, 21 May 2010 22:17:30 GMT

[quote user="Nick 'Batfink' Shackleton DipAVN(Surgical)VN MBVNA"]

[/quote]

Ohhh - thats our vets reasons for not giving nsaids with the premed

Re: Post Op Analgesia

Nick Shackleton — Fri, 21 May 2010 22:14:03 GMT

yeah, but no!

Multi-modual: more than one form of pain relief affecting different pain pathways

Preemptive: Giving pain relief prior to pain. As it is easier to treat pain prior to the incident rather than after it

Re: Post Op Analgesia

Phrin Vernon RVN — Fri, 21 May 2010 22:12:55 GMT

Depending on the cat/vet, we will use either buprenorphine & acp premed, with propofol ga, dom & torb +/- propofol , or dom torb & ket.

They all get onsior and long acting abs just after induction, and have had no probs with this.

Re: Post Op Analgesia

Mrs Dot Dot — Fri, 21 May 2010 22:06:02 GMT

We use Dom/torb/ket and m'cam... tend to think that metacam lasts for about 36hours in cats... all seem comfortable and no obvious problems so far

Re: Post Op Analgesia

Vicky RVN — Fri, 21 May 2010 21:51:19 GMT

But i was right though, wasn't i?!

Re: Post Op Analgesia

Vicky RVN — Fri, 21 May 2010 21:50:53 GMT

Yeah yeah alright smarty pants

Re: Post Op Analgesia

Nick Shackleton — Fri, 21 May 2010 21:49:30 GMT

[quote user="Vicky SVN"]

Our get vetergesic in premed, and metacam pre op. Pain relief is more effective given pre op than post op, so we always do it before. They never need any more than this. We don't generally give ABs to neuters.

[/quote]

The words your looking for is pre-emtive and multi-modal.

Re: Post Op Analgesia

Hannah25uk — Fri, 21 May 2010 19:48:48 GMT

.All our ops get pre op metacam and vetergesic with their premed even cat castrates. We don't give ab's to routine surgeries either and haven't had a problem.

Re: Post Op Analgesia

Nicola Smith — Fri, 21 May 2010 19:25:40 GMT

Ours get vetergesic in their premed then iv metacam when they are knocked out.

Re: Post Op Analgesia

Sally Howe — Fri, 21 May 2010 18:34:37 GMT

Our cat castrates get triple combination and metacam.

Re: Post Op Analgesia

Vicky RVN — Fri, 21 May 2010 18:18:33 GMT

Re: Post Op Analgesia

loobylou — Fri, 21 May 2010 17:08:20 GMT

Our cat castrates always get a nsaid either pre or post op.

Re: Post Op Analgesia

Kim Buckley — Fri, 21 May 2010 17:07:25 GMT

We use dom/torb/ket and pre op metacam. No ab's rountinely given. They don't go home on anything and all seem fine.

Re: Post Op Analgesia

Claire Cameron — Fri, 21 May 2010 16:58:51 GMT

[quote user="Nursie VIP"]Does anyone else give cat castrations meds post op?[/quote]

Hi,

Currently we use dom/torb for pre-med in our cat castrates and metacam.

No post op meds for these boys, we find they do fine at the minute.

We don't use ABs in routine ops either