Pain management

Local anaesthesia

• How to include a local anaesthetic within a multi-modal analgesia plan
• The anatomy of a nerve and place in the central nervous system
• How a local anaesthetic provides analgesia

Dental nerve blocks

• Innervation of the head
• Equipment required to perform dental nerve blocks
• Dental techniques for the dental arcade

Cardiovascular stabilisation of the trauma patient

• Understanding the fluid therapy options available
• How to best administer fluid therapy in a trauma patient

Analgesia for the trauma patient

• Understanding analgesic options in the trauma patient
• How to use CRIs in the trauma patient
• Understanding differences between cats and dogs in analgesic options

Drug free management: Owners must understand that medical analgesia is often vital to reduce suffering, especially at the start of the treatment of chronic pain. We cannot, by explaining that chronic and acute pain are distinguishable by the threat they pose to survival, teach our animal patients to be to be unafraid of their pain. We therefore need to reduce both the sensation and the emotion of pain and this process sometimes needs medication. Where the pain field has become exaggerated and expanded, physical therapies may be contraindicated until that field has been reduced. Rather than ‘drug free’ (which tends to give ‘drug use’ a negative sense), the physical therapies should be thought of as integrated; relatively safe; and relatively free of side effects. Their use may reduce the use of medicines; may positively contribute to the animal’s health and mobility; and, often, indirectly contribute to owner compliance because the therapist can continue to educate and to build on the plan. Physical therapies include but are not limited to: acupuncture; physiotherapy and hydrotherapy; laser; manipulation; and myotherapies of various kinds. This lecture will briefly describe the most common therapies, their indications, advantages and possible drawbacks.

Foundations of drug therapy – building the plan and an overview of NSAIDs: Medical treatments provide the cornerstone of most pain management plans, but how effective are they in addressing chronic pain? Osteoarthritis is a major cause of chronic pain and it is an excellent example of the need to properly understand how pain is being generated before attempting to resolve it. Management involves controlling the local disease, a source of nociceptive stimulation, while at the same time separately addressing non-nociceptive mechanisms, neuropathy and central processing. NSAIDs have been used widely and successfully to address pain in OA. We almost know too much about these drugs and our knowledge restricts our use and client acceptance due to risk of toxicity. However, there are other limitations in managing chronic pain using NSAIDs. The use of unlicensed medications to treat chronic pain about has increased greatly. But are they safe or effective? Properties do not easily translate between species as we found in the past with NSAIDs and more recently with tramadol. Medical agents are important tools in building a management plan but due consideration must be given to therapeutic targets, effectiveness, duration of use, practicality and common sense.

This webinar explains the concept of multi-modal analgesia and looks at the types of pain that are being treated in trauma patients. The webinar goes on to cover treatment options and examines how to tell is the treatment is effective. This one-hour webinar was first broadcast as part of BSAVA’s Learn@Lunch series. Learn@Lunch broadcasts are available to BSAVA members only and are free to attend - visit the education page of the BSAVA website for details of future Learn@Lunch webinars. Recordings will be available for 3 years via the BSAVA Webinar Library.

Rabbits and other small furry animals have evolved to hide their pain: a literal life saver for them but a challenge for the veterinary profession. We cover how to recognise pain in these patients, as well as analgesic approaches to chronic pain (covering drugs, acupuncture and more). Regions Now events comprise an introductory lecture with supporting content available one week before a live lecture. This is followed by a one-week online discussion forum allowing participants to offer observations about the lessons learned and describe their own experience in handling cases. Regions Now sessions are free to BSAVA members and available for non-members to book - visit the Regions page of the BSAVA website for details of future Regions Now events. Recordings will be available for 3 years via the BSAVA Webinar Library.

  Ian Self, Editor of the new BSAVA Guide to Pain Management in Small Animal Practice, addresses the issues of pain in companion animals – what is it, why does it matter, and what is the future of pain treatment?

Pain is a component of many ophthalmic diseases and the provision of adequate analgesia is an ethical obligation for all veterinary clinicians. This chapter considers the anaesthetic approach to the ophthalmic patient and encompasses the following aspects: analgesia; relevant aspects of ocular physiology; pre-anaesthetic assessment; formulation of an anaesthetic plan; intraoperative monitoring; postoperative care; special techniques, including provision of neuromuscular blockade.