Quarterly Newsletter

2014-May_IVG Newsletter-Ophtho-PainMgt

The IVG Hospitals Quarterly Veterinary Newsletter features articles of interest to the veterinary medical community, written by veterinarians and veterinary specialists at our four locations.

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| 6 | concentrations during surgery have been linked to postoperative cognitive, cardiovascular, musculoskeletal impairments. 2. Local anesthesia permits comfortable and quick arousal from anesthesia with little potential for unwanted systemic effects such as sedation or respiratory depression; analgesia derives from sensory blockade which SPARES motor and sympathetic function. 3. Recovery to mobility, appetite return, and cognitive function are vastly improved when local techniques are employed in the perioperative plan; morbidity is reduced. 4. Lastly, local anesthetics are recognized to have many beneficial effects beyond blocking nerve conduction, including broad anti-inflammatory effects (reduced production of eicosanoids, thromboxane, leukotriene, histamine, and inflammatory cytokines; and scavenging of oxygen free radicals) and even antimicrobial, antifungal and antiviral effects. All these effects of inexpensive lidocaine and other local anesthetics have been well documented in the human and veterinary literature for over a decade. These procedures are indicated for a variety of acute, chronic, oncologic, degenerative, and post-traumatic painful conditions. Although some patients respond to interventional procedures as uni-modal therapy, most chronic pain patients respond best when such interventions are part of a multidisciplinary approach (usually coupled with physical rehabilitation and the use of balanced medications). Interventional procedures may be therapeutic or diagnostic, the latter of which are administered to determine if pain is part of the disability, or if an anatomical area is the correct focus of treatment. LOCAL BLOCKS IN SURGICAL ANESTHESIA Surgical, acute local and regional blocks like epidurals and surgical nerve blocks have been widely utilized within the past decade for veterinary patients. In the veterinary acute or perioperative arena there is no need to question whether local/regional analgesia should accompany general anesthesia. Local blocks have become a basic premise of surgical general anesthesia. If one examines the literature from the last decade, it becomes clear that these techniques have several benefits for surgical patients: 1. Local blockade permits reduction of inhalant requirements the latter of which is inherently safer for patients; high inhalant Interventional pain management in animals is an application of image-guided procedures which benefit veterinary patients with both acute and chronic pain. Pioneering work in human pain management has led the way not only for perioperative nerve blocks, spinals and epidurals, but also for trigger point injections, peripheral nerve and nerve root branch blocks, sympathetic plexus blocks, intravenous infusions, radiofrequency lesioning, botulinum toxin injections, intra-articular and peri-tendinous injections, and spinal or epidural "desensitizing" implantations. Dr. Andrea L. Looney, DACVAA, CCRP supports all of the practices within the IVG network of hospitals. Andrea L. Looney, DVM, DACVAA, CCRP Interventional Analgesia: Part I

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