2022 ISFM Consensus Guidelines on the Management of Acute Pain in Cats

2021 ◽  
Vol 24 (1) ◽  
pp. 4-30
Author(s):  
Paulo V Steagall ◽  
Sheilah Robertson ◽  
Bradley Simon ◽  
Leon N Warne ◽  
Yael Shilo-Benjamini ◽  
...  
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Multimodal Analgesia ◽  
Evidence Base ◽  
Pharmacological Therapy ◽  
Assessment Tools ◽  
Mental Wellbeing ◽  
Team Approach ◽  
Analgesic Drugs

Practical relevance: Increases in cat ownership worldwide mean more cats are requiring veterinary care. Illness, trauma and surgery can result in acute pain, and effective management of pain is required for optimal feline welfare (ie, physical health and mental wellbeing). Validated pain assessment tools are available and pain management plans for the individual patient should incorporate pharmacological and non-pharmacological therapy. Preventive and multimodal analgesia, including local anaesthesia, are important principles of pain management, and the choice of analgesic drugs should take into account the type, severity and duration of pain, presence of comorbidities and avoidance of adverse effects. Nursing care, environmental modifications and cat friendly handling are likewise pivotal to the pain management plan, as is a team approach, involving the cat carer. Clinical challenges: Pain has traditionally been under-recognised in cats. Pain assessment tools are not widely implemented, and signs of pain in this species may be subtle. The unique challenges of feline metabolism and comorbidities may lead to undertreatment of pain and the development of peripheral and central sensitisation. Lack of availability or experience with various analgesic drugs may compromise effective pain management. Evidence base: These Guidelines have been created by a panel of experts and the International Society of Feline Medicine (ISFM) based on the available literature and the authors’ experience. They are aimed at general practitioners to assist in the assessment, prevention and management of acute pain in feline patients, and to provide a practical guide to selection and dosing of effective analgesic agents.

Acute Pain Management

2018 ◽  
Author(s):  
Nihar Patel
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Treatment Options ◽  
Postoperative Pain Management ◽  
Assessment Tools ◽  
Age Appropriate ◽  
Short And Long Term ◽  
Inflammatory Drugs ◽  
Postoperative Setting

Age-appropriate pain assessment and management is vital in the care of children with acute pain. Pain in children should be routinely and regularly assessed, documented, treated and reassessed with clear documentation. Poor pain management in the acute and postoperative setting can result in both short- and long-term consequences. The most effective analgesia plans are multimodal. This chapter focuses on the variety of treatment options for pain in the acute setting. Topics covered include age-appropriate pain assessment tools for children; the basics of age-appropriate pain management in children; as well as the role of opioids, nonsteroidal anti-inflammatory drugs, and patient-controlled analgesia in acute and postoperative pain management in children.

Considerations for neonatal and pediatric pain management

2019 ◽  
Vol 76 (19) ◽  
pp. 1511-1520 ◽  
Author(s):  
Pooja Shah ◽  
Anita Siu
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Pediatric Patients ◽  
Safety Data ◽  
Clinical Situation ◽  
Assessment Tools ◽  
Patient Specific ◽  
Pediatric Pain ◽  
Unique Challenge

Abstract Purpose Current literature and clinical practice guidelines on pediatric pain management are reviewed. Summary Acute pain is commonly present in neonatal and pediatric patients due to underlying disease states or procedures. Especially in institutions with limited pediatric pain services, it is imperative to describe the appropriate management of pain and pharmacotherapy options that are effective and safe in pediatric patients. Despite the knowledge of pain being an important aspect in the management of children, barriers exist, leading to suboptimal treatment. Addressing these barriers through education of healthcare practitioners, families, and patients will lead to optimizing the patient pain experience. Tools for pain assessment vary depending on the type of pain, the child’s age and understanding of pain, and the clinical situation. Pharmacotherapy options for pain management in neonates and pediatric patients include opioid and nonopioid agents. Efficacy and safety data on the use of medications for the treatment of pain in pediatric patients is described. The delivery of medication encompasses patient-specific factors and preferences. Strategies for opioid stewardship and management of iatrogenic withdrawal pose a unique challenge in pediatric patients. Conclusion The management of acute pain in neonates and pediatric patients should be a priority for all practitioners caring for these patients. Use of age-appropriate pain assessment tools and understanding of the mechanisms of action and roles in therapy of various nonopioid and opioid therapies can help optimize treatment of pain in neonatal and pediatric patients.

Acute pain

2021 ◽  
pp. 1151-1180
Author(s):  
Adrian Dashfield ◽  
David Kibblewhite
Keyword(s):  
Pain Management ◽  
Epidural Analgesia ◽  
Peripheral Nerve ◽  
Acute Pain ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Electrical Nerve Stimulation ◽  
Analgesic Drugs ◽  
Peripheral Nerve Blockade ◽  
Inflammatory Drugs

This chapter discusses the management of acute pain. It begins with an introduction which describes the benefits of acute pain management and the measurement of pain. Analgesic drugs are then described, including paracetamol; non-steroidal anti-inflammatory drugs (NSAIDs), and opioids (including their comparative efficacy). Patient-controlled analgesia (PCA), epidural analgesia, and continuous peripheral nerve blockade are described. Transcutaneous electrical nerve stimulation (TENS) and acupuncture are discussed. The management of the patient with persistent pain and a substance misuse disorder is also discussed. The chapter concludes with a discussion of non-opioid adjuvant analgesics.

scholarly journals Acute Pain Assessment Inadequacy in the Emergency Department: Patients’ Perspective

2022 ◽  
Vol 9 ◽  
pp. 237437352110496
Author(s):  
Jenni Hämäläinen ◽  
Tarja Kvist ◽  
Päivi Kankkunen
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Numerical Rating ◽  
Emergency Department Patients ◽  
Pain At Rest ◽  
Patients Perspective

For many patients, acute pain is a common cause to seek treatment in an Emergency Department (ED). An inadequate assessment could cause inappropriate pain management. The aim of this study was to describe and explain patients’ perceptions of acute pain assessment in the Emergency Department. The data were collected from ED patients (n = 114). Patients reported that nurses were asking about intensity of pain at rest, but only 52% during movement. According to the patients, the most common tools to assess acute pain were the verbal rating scale (VRS; 54% of patients), numerical rating scale (NRS; 28% of patients), and visual analogue scale (VAS; 9.7% of patients). Over twenty per cent of patients stated that ED nurses did not ask about the intensity of pain after analgesic administration. Twenty-four per cent of the patients were not pleased with nursing pain assessment in the ED. The assessment of acute pain is still inadequate in the ED. Therefore, ED nurses need to be more attentive to systematic acute pain management of patients in the ED.

scholarly journals Pain management in cat

2017 ◽  
Vol 58 (3) ◽  
pp. 257
Author(s):  
G. M. KAZAKOS (Γ.Μ. ΚΑΖΑΚΟΣ) ◽  
I. SAVVAS (Ι. ΣΑΒΒΑΣ) ◽  
D. RAPTOPOULOS (Δ. ΡΑΠΤΟΠΟΥΛΟΣ)
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Adrenergic Receptor ◽  
Multimodal Analgesia ◽  
Clinical Settings ◽  
Analgesic Drugs ◽  
Receptor Agonists ◽  
Analgesic Therapy ◽  
Inflammatory Drugs ◽  
Pain Recognition

Although cats are very popular pets, pain in this species is often underestimated. The reasons for this may include difficulties in pain recognition, unfamiliarity with the use of opioids or non-steroidal analgesic drugs, and with the application of local analgesic techniques. Proper pain management should always be undertaken mainly for medical and humane purposes. Pre-emptive and multimodal analgesia can aid significanly in postoperative pain alleviation. Nowadays, the veterinarian's armamentarium is equipped with a variety of agents in order to alleviate pain in cats. Non-steroidal anti-inflammatory drugs are often as effective as opioids. The latter are now used successfully for pain management in cats. Both classes provide safe analgesia, taking into account the differences in metabolism between cats and other species. Adjunctive analgesic therapy may be provided with the use of ketamine or a2-adrenergic receptor agonists. Loco-regional analgesic techniques can be used to effectively manage pain in a variety of clinical settings.

Pain in children

2018 ◽  
Author(s):  
Julia Wager ◽  
Boris Zernikow
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Cancer Pain ◽  
Acute Pain ◽  
Pain Assessment ◽  
Education For All ◽  
Special Focus ◽  
Assessment And Treatment ◽  
Specialized Service ◽  
Pain Patients

Pain management in children is a specialized service. Pain aetiology, assessment, and treatment vary at every age from pre-term foetuses at 23 weeks gestation to adolescence. In this chapter of European Pain Management advances in our understanding of pain assessment are reviewed, particularly in the use of developmentally relevant technology. Advances in acute pain, cancer pain, and in chronic pain are also reviewed, with a special focus on innovations in multidisciplinary treatments for chronic pain. There is a need to raise awareness and understanding of the needs of paediatric pain patients, and their family members. Education for all professionals who interact with pain patients is essential, as is the need to invest in specialized pain management services, and professionals, across Europe.

The pharmacology of the drugs used in acute pain

2011 ◽  
Author(s):  
Lesley Bromley
Keyword(s):  
Pain Management ◽  
Drug Treatment ◽  
Acute Pain ◽  
Route Of Administration ◽  
Analgesic Action ◽  
Acute Pain Management ◽  
Analgesic Drugs ◽  
The Past

Drug treatment is the mainstay of acute pain management. An understanding of the pharmacology of the drugs used is essential for rational acute pain management. Drugs that have a primary analgesic action have been used traditionally. Recently, adjunct drugs and combinations have been shown to be more effective than analgesics alone. In the past 20 years, the route of administration and the timing of analgesic drugs have played a greater part in efficient acute pain management.

Utility of multimodal analgesia with fascia iliaca blockade for acute pain management following hip arthroscopy

2013 ◽  
Vol 22 (4) ◽  
pp. 843-847 ◽  
Author(s):  
Aaron J. Krych ◽  
Sean Baran ◽  
Scott A. Kuzma ◽  
Hugh M. Smith ◽  
Rebecca L. Johnson ◽  
...  
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Hip Arthroscopy ◽  
Multimodal Analgesia ◽  
Acute Pain Management

Pain management

2019 ◽  
pp. 549-568
Author(s):  
John Curtin
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Rating Scales ◽  
Interdisciplinary Approach ◽  
Opioid Analgesics ◽  
Brief Pain Inventory ◽  
Assessment Tools ◽  
World Health ◽  
Numerical Rating ◽  
Strong Opioids

Pain is described as being whatever the experiencing person says it is, and their perception of pain is determined by their mood and morale and the meaning of the pain for them. Cancer pain is common, and prevalence is related to the stage of the illness: 59% in patients undergoing treatment, and 64% in those with advanced disease. Pain is multi-causal and multidimensional, and a holistic, interdisciplinary approach to assessment is necessary, encompassing physical, psychological, social, and spiritual aspects of pain (together are ‘total pain’). A narrative approach to pain assessment is helpful, keeping the focus on the patient and their experience. Pain assessment tools can also be used to identify where pain is and how much it hurts. These include: pain body map, visual analogue scales (VAS), verbal rating scales (VRS), numerical rating scales (NRS), and Brief Pain Inventory (BPI). Classifications of pain include acute and chronic pain, nociceptive pain caused by the stimulation of nerve endings, and neuropathic pain caused by nerve dysfunction or compression. Analgesic drugs may be given according to the World Health Organization's pain relief ladder: step 1, non-opioid analgesics such as paracetamol and non-steroidal anti-inflammatory drugs; step 2, mild opioids like codeine with or without non-opioid analgesics; and step 3, strong opioids like morphine with or without non-opioid analgesics. Non-pharmacological interventions for pain management include transcutaneous electrical nerve stimulation (TENS), massage, distraction, relaxation, breathing exercises, comfort measures, and presence of the nurse. Effective communication at all stages of management is essential.

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