Anaesthesia regulates patient consciousness with marginal impact on analgesia. Most anaesthetic induction and inhalation agents have poor analgesic properties. When patients undergo painful surgical procedures, signs of pain perception (20% rise in BP, HR, or RR baseline) may be countered by an increase in inhalation concentration. The inherent danger to the patient is further cardiovascular depression. In older, or compromised patients, this is not a good position to be placed. In many respects it is a little like using a sledgehammer to crack a nut. While the surgeon wants better pain control, they end up with a deeper, more depressive anaesthetic.
The surgery pain plan may include one or more of the following techniques:
local nerve block
Pain breakthrough can still happen. If & when it does, staff should be encouraged to reach for analgesic medications rather than the % dial on the vaporiser. A range of products can be used. Ketamine & Dexdomitor can both be given at micro dose volumes. This avoids some of the less desirable features associated with standard dose rates. A range of opioid medications can be used. These can be given when required, or as a CRI once breakthrough pain is controlled.
The same strategy can be used during patient recovery. Care needs to be taken to differentiate pain from dysphoria. These animals tend to worsen rather than settle if given opioids or ketamine.
Anaesthetic Pro contains breakthrough pain dose volume calculations (along with a host of other applications).