Anesthesia

Anesthesia is a class of drug that blocks some functions of the central nervous system thus creating a loss of sensation and muscle control. Anesthesia ensures that the patient stays at rest, or does not move, while undergoing a procedure. This is the safest way to immobilize the body and prevent potential injury from movement while doing invasive surgery or dentistry. It also lowers the immediate sensitivity but not the latent response to pain, which is why pain management is still needed. Epidural Anesthesia drugs may be injected as an epidural along the spine between two vertebrae for a regional or partial anesthesia block. General Anesthesia drugs are administered in the form of a breathable medical gas and/or an injection. An intubation tube with oxygen supply is needed to maintain control of the airway should any issues arise. Some anesthesia drugs are reversible with a reversal drug in case there is an adverse reaction while others wear off with some time. Anesthesia carries very low risk when used by a trained professional such as your veterinarian.

Pain Management

Pain medications are part of the pain management process. Pain is the body's way of letting us know that something is wrong so that we can address it before things get worse. The pain would eventually go away if the problem is resolved or if the body has reached a certain level of healing. In that way, pain is a good thing, but no one likes to feel pain so we would rather turn it off once we have acknowledged the problem. Injuries or wear and tear can cause pain, but life-improving surgeries may also cause pain during and after surgery until healing is complete. That is why pain medications are used. Signs of pain from injury or natural wear and tear of the body includes:

• Sleeping more or less active than usual (indicators of arthritis or joint pain)
• Groans or moans in pain
• Soreness to touch or contact
• Change in social behavior such as hiding
• Other Change in behavior (including eating habit)
• Observable injury (cut, bruise, bite, swelling, redness, sting, fracture, break, etc)
• Pain associated with movement (limping or your veterinarian may perform a physical exam to determine localized motion pain)
• Diagnostics such as X-rays may reveal development of arthritis, or fracture, etc as the source of pain
• Expected or known pain from surgical recovery

Because your pet is not able to explain the type or source of the pain, the above methods are the typical methods for your veterinarian to determine the problem.

There are different types of pain medications that comprise the pain management process and they work in different ways. Different types of pain medications work along different chemical pathways within the body and as a result may stop different types of pain. Multiple pain medications are used together as part of a pain management protocol. The pain management protocol may require different dosing of each type of medication and may be given at different times or for different reasons throughout the procedural duration. A particular pain management protocol may dictate giving a combination of drugs in a dosing ratio in one single injection to elicit a combined effectiveness. Pain medications are used for pre-anesthetic, induction, and post-operation phases of a dental or surgical procedure. Medication dosing is often a function of the weight of the patient, but may be adjusted for age and health status to give a lesser or stronger effect as needed. Below are different pain medication types that function differently:

Local Blocks

These pain medications block local pain receptors or nerve endings, which help to numb the local area where injected. One example of these drugs is Lidocaine.

NonSteroidal Anti-Inflammatory Drugs (NSAIDS)

These medications block the inflammatory pathway. Inflammation is one contributing factor to pain. These drugs, available as injection and/or pill, are systemic and can act on both dispersed areas of the body as well as targeted painful areas. One example of these drugs is Carprofen. These pain medications are good for arthritis as well, but must be used with strict instructions from your veterinarian to avoid liver issues or reactions to other drugs such as steroids.

Neurological Pain Medications

These drugs work along the neurological pathway, which means they affect nerves directly by limiting the firing of pain signals to the brain. These drugs may sometimes induce low levels of sedation. One example of these drugs is Gabapentin.

Sedatives

Sedatives suppress the central nervous system to lesser extent with some pain relieving effect as a result. While sedated, a patient will have limited control over their awareness and mobility. Sedatives allow for a more compliant and less agitated patient thus reducing injury from struggling with the pet. Some sedatives are reversible with a reversal drug.

During a procedure, sedation, anesthesia, and pain medications are used together as part of the overall treatment protocol. For complex or invasive procedures such as major surgery or dental procedures, both anesthesia and pain management protocols are used. In situations such as wound care or less invasive localized procedures, anesthesia may not be necessary. Your veterinarian will let you know which procedures require anesthesia and which ones only require pain management and/or sedation.