Pain Management and Anesthesia
What this domain tests
Pain management and anesthesia focuses on pain pathways, assessment, multimodal analgesia, local blocks, and chronic pain. It differs from the anesthesia domain by emphasizing analgesic choices and pain scoring.
Core rules
- Pain involves transduction, transmission, modulation, and perception; multimodal therapy targets more than one step.
- Assess with a validated scale plus behavior, posture, appetite, and physiologic signs.
- Opioids are mu agonists for moderate to severe pain; watch for respiratory depression and dysphoria.
- NSAIDs inhibit COX; avoid in dehydrated, renal, or GI-ulcer patients, and use extra caution in cats.
- Local anesthetics require a maximum-dose calculation; bupivacaine is longer-acting than lidocaine.
- CRIs and adjuncts include ketamine, lidocaine, gabapentin, and alpha-2 agonists; use only with a plan.
- Treat pain early; chronic osteoarthritis benefits from weight control and rehabilitation.
Worked example
A 10 kg dog is prescribed meloxicam 0.2 mg/kg SC once. Total dose = 10 × 0.2 = 2 mg. The injectable is 5 mg/mL, so volume = 2 ÷ 5 = 0.4 mL. Record the pain score before and after treatment; reassess renal and GI risk.
Traps that cost marks
Assuming a quiet patient is pain-free; using NSAIDs in a cat without caution; exceeding local anesthetic dose; ignoring dysphoria; failing to reassess after analgesia.