Pain Management for Veterinary Technicians and Nurses (eBook)

Stephen Niño Cital, Tasha McNerney, Darci Palmer (Herausgeber)

eBook Download: EPUB

2024 | 2. Auflage
1291 Seiten
Wiley (Verlag)
978-1-119-89239-7 (ISBN)

Infos

A practical guide for veterinary technicians and nurses on essential concepts of animal pain management

Pain management is an essential aspect of medical care, but in the field of veterinary medicine it poses unique challenges. Learning to recognize animal pain, to advocate for patient care, and to build and implement pain management protocols allows veterinary nursing teams to be more effective and vastly improves patient outcomes. Mastering this aspect of veterinary medicine means developing an understanding of pain physiology and pharmacology of pain management drugs, the necessity of various analgesics in different care environments, and how to tackle obstacles to animal pain care.

Pain Management for Veterinary Technicians and Nurses, 2^nd edition provides a robust update to the only textbook on this subject directed at veterinary technicians in the US. Already a standard text for its coverage of small companion animals, this book now also covers analgesic techniques in horses, lab animals, and zoo species, making it a valuable resource for technicians in a range of professional and clinical situations. Updated to incorporate the latest evidence-based medicine, it promises to continue as the essential introduction to this oft-overlooked but critical dimension of veterinary medicine.

Pain Management for Veterinary Technicians and Nurses readers will also find:

• Multiple expanded chapters as well as a new chapter covering pain management for c-sections and neonatal care
• A new emphasis on critical thinking and a holistic approach to patient care
• Coverage of complementary and alternative therapies
• Expanded illustrations of regional analgesia techniques

Pain Management for Veterinary Technicians and Nurses is a valuable guide for veterinary technicians in both general and specialized anesthetic practice, as well as veterinary students and general veterinary practitioners.

Stephen Niño Cital, RVT, RLAT, SRA, CVPP, VTS-LAM, is a Veterinary Technician Specialist in Research Anesthesia and Certified Veterinary Pain Practitioner. He is a Lab Manager for Howard Hughes Medical Institute at Stanford University and is an administrator for the Veterinary Anesthesia Nerds, LLC. Stephen is also a partner at Remedy Veterinary Specialists leading the pain service in the San Francisco Bay Area of California.

Tasha McNerney, CVT, CVPP, VTS, is a Veterinary Technician Specialist in Anesthesia and Analgesia and a Certified Veterinary Pain Practitioner. She is a board member of the International Academy of Pain Management and founder of Veterinary Anesthesia Nerds. She is the Training Director at a large specialty referral hospital in the Philadelphia area.

Darci Palmer, BS, LVT, VTS, is a Veterinary Technician Specialist in Anesthesia and Analgesia and a Clinical Teaching Specialist at Tuskegee University College of Veterinary Medicine. She is Executive Secretary for the Academy of Veterinary Technicians in Anesthesia and Analgesia and Administrator for Veterinary Anesthesia Nerds. She works as a private consultant, author, and lecturer in Auburn, AL.

Textauszug

1
Advancing Veterinary Pain Management into a New Era

Mary Ellen Goldberg

Independent Contractor & Mannheimer Foundation Inc., Boynton Beach, FL, USA

“The greatest evil is physical pain.”

Saint Augustine of Hippo (386)

1.1 Introduction

A living being, from the moment of birth, seeks pleasure as the ultimate good while rejecting pain as the ultimate adversity and does their best to avoid it. Pain is based on an anatomical and physiological foundation. It is the intent of this chapter to historically look at human pain, proceed forth into veterinary pain, and conclude with a veterinary technician's pivotal role moving forward in pain management today.

1.2 Brief History of Human Pain Management

Western cultural identity has, in part, been influenced by ancient Greek texts such as The Iliad and The Odyssey by Homer because of the emphasis these stories placed on pain. Sophocles continues to describe pain almost as an independent being that seizes possession of the subject, invades it, and takes over. Thus, words like consuming or devouring are used to describe the ill being (Rey 1993). Galen of Pergamon was a Greek physician, surgeon, and philosopher in the Roman Empire. Galen is known today for classifying the different forms of pain which have been handed down to modern times: Pulsific or throbbing, gravative or weighty, tensive or stretching, and pungitive or lancinating (Rey 1993).

In contrast to Western medicine, which can be traced back to Hippocrates, Chinese acupuncture was fully developed by the end of the second century BCE (before the common era). Among many ancient civilizations, such as kingdoms in Africa, Sumer, China, Mesoamerica, and the Indus‐Ganges, China is the only civilization where acupuncture was well documented 2000 years ago that still survives (Chiu 2014).

Before the advent of modern anesthesia, humans used diverse means to diminish pain, including pressure or ice to numb extremities. Many indigenous cultures had their own understanding of pain and often took a more holistic approach to managing discomfort, something that we see a reawakening of today. They administered herbal medicines including mandragora, hemp‐marijuana, and opium. Some used fermented drinks that contained alcohol used not only for pain but also for ceremonies and recreation. The Incas, as an example, knew of the topical effects of coca/cocaine leaves, but they had no way to administer it other than placing coca‐laced saliva into wounds. Hua Tuo (in the second century CE) was a Chinese physician and surgeon who is best known for his surgical operations and the use of mafeisan, an herbal anesthetic formulation made from hemp. Using a preparation of hemp and wine, he was able to make his patients insensitive to pain (Tubbs et al. 2011). Other Mesoamerican Indigenous and Aboriginal Australian people not only used herbal and mechanical means for pain relief but also incorporated ceremony, showing a deep understanding of the interconnection between physical, emotional, and spiritual health in all creatures. Unfortunately, many of these ancient herbal remedies and other culturally significant practices were banned or lost during colonization, only to be “rediscovered” in modern times by the same but very distant relatives of the original colonizers. The loss or suppression of indigenous peoples' healing practices leaves us with a “Western” or “Eurocentric” perspective in textbooks on the evolution of pain management (Eger et al. 2014; Geck et al. 2020; Quiñonez‐Bastidas and Navarrete 2021; Carmona Rosales 2021; Wren et al. 2011).

René Descartes, a French scientist and philosopher, was the first recorded person to claim that pain comes from the brain. His study focused on phantom limb pain and since there was no limb to feel pain, he concluded that pain must come from the brain. Descartes opened the door to the understanding that the brain was a key component of pain, though it would be centuries before the complete connection between the brain, nervous system, and pain was made (Rey 1993).

Albrecht von Haller was interested in the reactions of fibers and how to distinguish between the irritability of muscle fiber – which he called contractibility – and the excitability of nerve fibers – which he called sensitivity (Olson 2013a).

Pierre Jean George Cabanis' work incorporated a psychophysiological approach to pain, which included the emotional component. His work led to new techniques such as using electrical stimulation for the treatment of pain.

Xavier Bichat represented a passage from organic sensitivity to animal sensitivity and the threshold concept. Bichat's contribution to pain medicine was his discovery of the importance of the sympathetic nervous system (Olson 2013a).

The early part of the nineteenth century saw the development of health clinics, which increased interest in the study of pain. Pain research at this time remained within the framework of specificity theory advanced by Johannes Müller and later Maximilian von Frey, which saw pain as an independent sensation with its own sensory apparatus. Müller proposed a theory for pain, which considered findings from physiology, historical observations, pathology, and integrated psychological dimensions of pain. He believed that pain was not imaginary – that it could occur without an external stimulus. Von Frey was trying to identify points on the skin that responded specifically to one of the four cutaneous sensations: touch, heat, cold, and pain. To accomplish this task, he invented what he called an esthesiometer, where the stimulus consisted of hair (Olson 2013b).

In 1965, Ron Melzack and Patrick Wall proposed a theory suggesting that neural mechanisms in the dorsal horn of the spinal cord could act as a “gate,” increasing or decreasing the flow of nerve impulses from peripheral fibers to the spinal cord cells projecting to the brain. In other words, the spinal cord “gate” either blocks pain signals or lets them pass onto the brain (Melzack and Wall 1965). Today, the gate control theory continues to thrive and evolve despite considerable controversy. The technology of spinal cord stimulation is also based on the gate control theory where products approved by the FDA are already on the market.

In 1973, John Bonica, the founding father of the modern‐day field of pain medicine and the driving force in establishing the International Association for the Study of Pain (IASP), proposed that relief of pain is a basic human right (Jackson and Norman 2014).

1.3 Veterinary Pain Management Through the Centuries

The surviving records on the advancement of veterinary medicine occurred during the Greek, Roman, and Byzantine eras. During this period, many species were investigated, with primary attention paid to the horse.

The development of nailed‐on horseshoes was a major technological step that enhanced the performance of draft and cavalry horses in the Dark Ages. The Celts were first to use red hot iron to fit under the strong rim of the horse's hoof. The Islamic world chose lighter shoes that could be shaped cold (Dunlop and Williams 1996).

During the Middle Ages, mandragora (or the root of the mandrake plant) was made into an anesthetic potion administered to the patient (human or animal) before surgery or cautery (Eger et al. 2014). It induced a deep sleep likely due to the plants natural production of deliriant hallucinogenic tropane alkaloids (atropine, scopolamine, and hyoscyamine) (Roberts and Wink 1998).

In 1656, Christopher Wren (the architect for St. Paul's cathedral and a founder of the Royal Society) infused wine and ale from a syringe made of a dog's bladder, through a goose quill needle into the vein of a dog. The dog survived the experiment. Wren later gave opium intravenously via a quill to dogs, causing unconsciousness in some animals, but killing others. Wren's experiment was the first known injection to produce anesthesia (Moon 2021).

Gasses and vapors later known as anesthetics had been synthesized or isolated before (ether, nitrous oxide, and carbon dioxide) but would be more regularly synthesized from 1798 through 1846 for research and medical use. In 1798–1800, Humphry Davy used nitrous oxide for recreation and research, noting its capacity to diminish or even abolish pain. He suggested its use for surgery, but no one noticed (Ramsay et al. 2005). In 1823, Hickman used carbon dioxide to cause what he called “suspended animation,” a state that permitted apparently painless surgery in animals, but no one noticed (Eger et al. 2014). In the 1840s, William Clarke, Crawford Long, and Elton Romeo Smilie each administered ether in amounts sufficient to permit surgery to be undertaken without pain. But they thought too little of what they had done, or didn't know what they had done, to request public credit for their accomplishment and no one noticed (Keys 1996).

Veterinary anesthesia/analgesia has paralleled human anesthesia/analgesia for the most part, but also still lags in many ways. The two have been intimately intertwined, each contributing to the advancement of the other. The...

Produkt-Details

• Erscheint lt. Verlag: 17.12.2024
• Sprache: englisch
• Themenwelt: Veterinärmedizin
• ISBN-10: 1-119-89239-2 / 1119892392
• ISBN-13: 978-1-119-89239-7 / 9781119892397