Post op pain relief

RE: Post op pain relief

Julian Earl — Thu, 02 May 2019 12:41:15 GMT

Back in about 1997 there was a short communication in the Veterinary Record indicating that for cat speys, carprofen was as effective as pethidine so I have always relied mainly on NSAIDs like carprofen or meloxicam but often with Vetergesic* as well at the pre-med-stage. A human consultant tells me that NSAIDS do impede healing, inflammation being the first stage of the healing process. Has anyone seen any wound breakdown likely to be attributable to anti-inflammatory effects of a NSAID? Not me...

*Other brands to Vetergesic are available!

RE: Post op pain relief

Jo Murrell — Thu, 02 May 2019 11:20:57 GMT

I think its right to be wary - but if you are monitoring blood pressure you can treat hypotension promptly - by turning down the iso (if using iso), a fluid bolus or ephedrine. This should decrease the risk of renal complications from NSAIDs.

RE: Post op pain relief

Lydia Brichta — Thu, 02 May 2019 11:12:53 GMT

We are wary of preop NSAIDs due to possible BP drops during surgery and potentially we would then be causing renal damage

RE: Post op pain relief

Jo Murrell — Thu, 02 May 2019 10:21:34 GMT

There is evidence in dogs that NSAIDs given pre-op prior to ovariohysterectomy is superior to post-op administration and prevents central sensitisation which is advantageous. However if you are giving NSAIDs pre-op I do think you should be monitoring and treating hypotension to reduce the risk of renal complications should hypotension occur during anaesthesia.

RE: Post op pain relief

Clive Ansell — Thu, 02 May 2019 10:17:34 GMT

I prefer nsaid's pre op with the premed, as long as their is no clinical indication otherwise. Never had an problems with it.

Where I am working at the moment, there seems a lot of fussing and flapping about it, with many insisting it MUST only be given post op on recovery. It is causing friction within the ranks. Most of the RVN's prefer giving it pre op.

RE: Post op pain relief

Julie Innes — Thu, 02 May 2019 09:11:21 GMT

I do what the nurses tell me, on a patient to patient basis!

RE: Post op pain relief

Jo Murrell — Thu, 02 May 2019 07:59:38 GMT

I would assess them for pain and see whether they reach the criterion score for an extra dose of methadone at 4 hours post premedication. The Glasgow Composite Pain Scales can be freely downloaded from the web and are quick to complete - the nurses are best placed to carry out pain scoring - and then give another dose if required.

RE: Post op pain relief

Michael Woodhouse — Thu, 02 May 2019 02:25:39 GMT

NSAID at pre-med or induction. Remember the concept of wind up. Analgesia works better before pain caused. Basic stuff.

RE: Post op pain relief

bevs2251 — Thu, 02 May 2019 02:23:14 GMT

Depends on the case. For basic desexings, no (unless big, fat old female Labrador). I do give Temgesic post-op for lengthy dentals with +++ extractions, and also send home on oral (sublingual for cats). Probably would also for any other lengthy, painful surgery + they'll sleep better.