Local and regional anesthesia.

Local anesthetics have the unique ability to produce complete blockade of sensory nerve fibers and prevent or pre-empt the development of secondary (central) sensitization to pain. For this reason, local and regional anesthetic techniques are often used with opioids, alpha 2-receptor agonists, dissociatives, and anti-inflammatory drugs as part of a multimodal strategy to manage pain. Lidocaine and bupivacaine are the local anesthetics used most commonly in dogs and cats. Lidocaine has a fast onset (10-15 min) and an intermediate duration of action (60-120 min), and is used for short diagnostic and surgical procedures. Bupivacaine has a slow onset (20-30 min) and a long duration of action (240-360 min), and is used to control pain both preoperatively and postoperatively. Local anesthetics are relatively safe if they are administered correctly. Administration of an excessive dose and accidental intravenous administration are probably the most common causes of systemic toxicity in small animals. Doses of local anesthetics, especially those for cats and small dogs, should always be calculated carefully. In many animals, the most simple and elegant way to control pain perioperatively is to perform a local or regional anesthetic block. Veterinarians should not hesitate to incorporate local and regional anesthetic techniques into their pain management strategies for dogs and cats.     

Home care for the veterinary dental patient

There is a dizzying array of home care products and aids available for veterinary clients to use for their pets. Although it can be confusing for veterinarians to determine which products to use and when, do not leave it up to your clients to decide for themselves. For those animals that need home care, take the time to discuss the situation with the owner and explain what they need to do. Listen to their thoughts and concerns, consider the animal involved, and then customize a program based on the individual situation.     

Pain management for laminitis in the horse

The inability to control pain is the most common reason for cessation of treatment and euthanasia in cases of laminitis, yet pain also serves a unique protective function in these cases, particularly in the acute phase when lamellar integrity is weakened. Successful analgesia requires an understanding of the disease pathophysiology, the sources of pain in laminitis, methods of serial pain evaluation, and methods of analgesia including systemic and regional techniques. This review discusses the approach to analgesia including detail of traditional and novel analgesic medications and techniques with specific reference to the laminitis case.     

Regional anesthesia and analgesia for oral and dental procedures.

Regional anesthesia and analgesia benefit the client, the patient, and the practitioner, and their use is becoming the standard for care. Familiarity with the processes involved in the generation of pain aids in understanding the benefits of preemptive and multimodal analgesia. Local anesthetic blocks should be a key component of a treatment plan, along with opioids, nonsteroidal anti-inflammatory drugs, N-methyl-D-aspartate receptor antagonists, and other therapies. Nerve blocks commonly used for dentistry and oral surgery include the infraorbital, maxillary, mental,and mandibular blocks.     

Local and regional anesthesia in cattle.

Although general anesthesia commonly is used in cattle, there are some risks with its use. Local or regional anesthesia is safe and effective and is still the most desirable procedure in many situations. Many surgical procedures can be performed safely and humanely in cattle by using a combination of physical restraint, mild sedation, and local or regional anesthesia. Local anesthetic techniques are usually simple, inexpensive, and provide a reversible loss of sensation to a relatively well-defined area of the body.     

Pain management in horses and farm animals

Objective: This review discusses the different analgesic drugs and routes of administration used in large animals for acute pain management. General guidelines and doses are given to assist in choosing techniques that provide effective analgesia. Etiology: Noxious stimuli are perceived, recognized, and localized by specialized sensory systems located at spinal and supraspinal levels. Diagnosis: Localizing the source of the noxious stimulus as well as understanding the behavioral aspects and physiological changes that result from such insult is important to adequately diagnose and treat pain. Pain assessment is far from being definite and objective; not only are there species differences, but also individual variation. In addition, the behavioral and physiological manifestations vary with the acute or chronic nature of pain. Therapy: Pain management should include (1) selecting drugs that better control the type of pain elicited by the insult; (2) selecting techniques of analgesic drug administration that act on pathways or anatomical locations where the nociceptive information is being processed or originating from; (3) combining analgesic drugs that act on different pain pathways; and (4) provide the best possible comfort for the animal. Prognosis: Providing pain relief improves the animal's well being and outcome; however, interpreting and diagnosing pain remains difficult. Continuing research in pain management will contribute to the evaluation of the pathophysiology of pain, pain assessment, and newer analgesic drugs and techniques.     

Pain management in ruminants.

Based on the available literature, the most important tool available in modern veterinary medicine is preemptive analgesia. Veterinarians must capture "opportunities" to prevent the onset of pain, prevent noxious stimuli or their perception, and limit the pain-stress-distress cascade that results in altered behavior and deviation from physiologic norms. Rational treatment of pain requires an appreciation of its consequences, a fundamental understanding of the mechanisms that are responsible for its production,and a practical appreciation of the analgesic drugs that are available. The goal of pain treatment should be to restore normal (physiologic) pain responses and to eliminate pathologic pain processes. In this context, pain therapy should be directed at the multiple mechanisms (multimodal therapy)responsible for its production, and analgesic therapies should be instituted before (preemptive therapy) pain is initiated (eg, surgery) whenever possible.     

Pain mechanisms and their implication for the management of pain in farm and companion animals

Over the last two decades there has been a dramatic increase in the literature relating to the mechanisms and management of pain in domestic animals. Understanding the mechanisms of pain is crucial for its effective management. This review highlights the current understanding of the neurophysiology of nociception and the plastic changes involved in chronic pain states. Additionally, we describe a range of novel molecules and pathways that offer opportunities for the development of mechanism-based analgesic therapies. Pain management in animals is limited by pain assessment which remains highly subjective, with clinicians relying on indirect measures of pain, using rating scales and (less frequently) quantifiable physiological and behavioural parameters. The need for a systematic approach which would assess different pain components is well justified. Species-specific issues on pain assessment and management in mammalian companion and farm animals are addressed in the later part of this review.     

A review of ophthalmic local and regional anesthesia in dogs and cats

Objective

Orbital and globe surgeries are commonly performed in companion animals and are considered to cause moderate to severe pain. Regional anesthesia techniques can provide complete sensory blockade, analgesia for painful procedures and improve surgical conditions. The purpose of this review is to summarize local and regional anesthesia techniques for ophthalmic surgery in dogs and cats with emphasis on veterinary publications in the past 12 years.