Best CRI for analgesia in pancreatitis?

RE: Best CRI for analgesia in pancreatitis?

David Mills — Thu, 19 Jan 2017 02:13:43 GMT

Usually start with meth only.

Lidocaine in infusions stops working after 4 hours.

RE: Best CRI for analgesia in pancreatitis?

John Flynn — Wed, 18 Jan 2017 22:52:37 GMT

A previous discussion few years back on methadone in CRI's if of interest:

https://www.vetsurgeon.org/uk/small_animal/f/9/t/20510.aspx

RE: Best CRI for analgesia in pancreatitis?

Edward Jones — Wed, 18 Jan 2017 10:55:10 GMT

I use http://vasg.org/ routinely to plan my CRI. They have spreadsheets which do the calculations for you, which I then print out and use as part of the clinical records.

There are several spreadsheets available, although I have only ever used the Methadone, Lidocaine, Ketamine version ( http://vasg.org/spreadsheets/unified_calculators/unified_calculators_03_12_11/analgesic_cris_iv_fluid_bag/Methadone_LK_Sx_Fluid_CRI_Kgs-Lbs_03_12_11_locked.xls ), and I often omit the Lidocaine and Ketamine, depending on clinical indication.

RE: Best CRI for analgesia in pancreatitis?

Charlie Lyon — Wed, 18 Jan 2017 10:03:13 GMT

Thanks for your help, will be very useful for future cases.

Unfortuantely she deterioated rapidly and started to seizure so she was PTS. Suspect a necrotising pancreatitis with DIC at the end.

RE: Best CRI for analgesia in pancreatitis?

grumpyoldman — Wed, 18 Jan 2017 00:13:40 GMT

As above but a smidgen of midazolam and zispin will keep it eating , which is apparently helpful with survival times

RE: Best CRI for analgesia in pancreatitis?

Glen McIntosh — Tue, 17 Jan 2017 17:09:55 GMT

1. Saline is an all round safe bet. But I tend to use hartmans for most of my CRIs where possible (except calcium or phosphate cri's of course), and you can certainly put methadone, lignocaine and ketamine in hartmans without probs.

2. I prefer FLK (fentanyl, lignocaine and ketamine). There was a school of thought that you shouldn't use methadone as a CRI, I can't remember the reasoning, but I think that particular bit of dogma has been debunked.