Anesthesia & Pain Management
Anesthesia is a necessary part of many diagnostic and therapeutic procedures. By providing anesthesia, we ensure that the procedure can be performed as safely and humanely as possible. While anesthetic drugs carry some risks of side effects and complications, we make every effort to select the appropriate drugs for each patient and monitor each patient carefully throughout the anesthetic procedure and recovery.
Choosing the correct anesthesia drugs requires an understanding of the patient’s underlying medical conditions, the patient’s specific level of anxiety at being in the hospital, and the potential for pain to be part of the planned procedure. The use of "pre-medications" to provide mild sedation and pain reduction can allow a reduction in the use of injectable or inhalant general anesthetics.
Depending on the length of the planned procedure and the depth of anesthesia required for the procedure, the appropriate monitoring equipment is utilized. These may include:
- A pulse oximeter (to monitor the level of oxygen in the patient’s blood)
- An electrocardiogram or EKG (to monitor the heart rate and rhythm)
- A blood pressure monitor
- An end-tidal carbon dioxide monitor (to monitor breathing effectiveness)
However the most important monitoring tool is the experience and attentiveness of our trained technicians. The veterinary technician providing anesthesia is trained to continually assess the patient’s heart rate, breathing rate, temperature, pulse quality, and level of anesthesia (how deeply asleep they are). They are also trained to respond to any changes in these parameters by adjusting or changing the anesthetics, providing fluid therapy or other medical interventions, manually breathing for the patient, or seeking help from a critical care clinician.
While any anesthetic procedure carries some risks, because of the training and expertise of the veterinarians and technicians at OSVS, anesthetic complications are extremely rare.
There have been tremendous advances in the understanding that animals feel pain in much the same ways that humans do. At OSVS, we know that our clients want their pets to be as comfortable as possible. Pain is a major factor in a pet’s quality of life overall, but can also play a role in a pet’s ability to recover from illness or injury.
Acute or Post-Operative Pain
Patients treated at OSVS are often suffering from injuries or recovering from surgical procedures or medical illnesses that may be causing some pain. There are numerous medications available to treat acute and post-operative pain. Effective pain management often involves a multi-modal strategy directed at both inflammation and pain perception. Because controlling acute pain can require high doses of these medications, careful monitoring is necessary to allow comfort to be provided to the patient without the risk of unwanted side effects. To accomplish this, medications are often delivered in a carefully titrated continuous-rate-infusion (CRI), which can be adjusted to the patient’s needs and decreased as the pain being experienced starts to resolve. By combining different types of medications, such as anti-inflammatories, narcotics, local or "numbing" anesthetics, and sedatives to reduce anxiety, the doses (and risks) of these drugs can be minimized.
There are numerous conditions that can cause chronic pain in pets. The most common being arthritis or other chronic orthopedic conditions. The development of a treatment plan must take into account multiple issues.
- A thorough investigation of the cause of the pain may reveal a condition that could be cured or greatly improved through medical or surgical treatment.
- All medications used to treat pain carry some risk of side effects. The degree of pain should determine the level of drug therapy instituted.
- In order to minimize side effects, risk factors should be determined for each patient, including the presence of any kidney or liver dysfunction. This is particularly important when non-steroidal anti-inflammatory medications are being considered, and blood work is often recommended prior to starting therapy.
The veterinarian will often choose a combination of medications determined in a stepwise fashion and tailored to the pet’s specific needs and reaction to medication. Many pet owners report a significant improvement in their pet’s quality of life once they start medication.
Pre-emptive Pain Management
When an injury or surgery causes pain, it sensitizes the nervous system and can lead to an amplified degree of pain sensation. The use of local anesthetics, which numb the area where the surgery is going to happen, can prevent this sensitizing from happening and decrease the amount of medication that will be needed to treat the pain after surgery. These local anesthetics can be injected around the surgery site, or around a nerve that would transmit the pain sensation from the surgery site, or sometimes around the spinal cord (with an epidural injection) to prevent large areas of pain sensation from getting to the brain. The use of local anesthetics is often part of a multi-modal strategy to ensure that our patients are as comfortable and stress-free as possible.