KEY POINTS

• The number of geriatric veterinary patients presented for anesthesia appears to be

increasing.

• Proper patient preparation and vigilant monitoring are the best defense against anesthetic

problems in the geriatric animal.

• Monitoring should include pulse oximetry, end-tidal CO2, blood pressure monitoring,

electrocardiogram, and temperature.

• There is no “ideal” anesthetic combination for all geriatric animals.

Effective pain management is not an individual endeavor. It requires a team approach involving everyone who participates in patient care. Veterinary technicians constitute a vital force in this effort. A successful technician understands the goals of pain control and the analgesic options. Combining keen observation with good technical skills, the technician functions as a true patient advocate who appropriately assesses requests and administers analgesics to his or her patients.

Article Outline

• Definitions
• Principles of pain management
• • Assessment of pain
  • Management of pain
  • • Reducing the input
    • Reducing the result of the input
    • Minimizing facilitation
    • Blocking perception
• Preoperative concerns
• Induction and maintenance of anesthesia
• • General anesthetics
  • • Venous access and intubation
  • Maintenance of anesthesia
  • Monitoring the patient
  • • Monitoring cardiovascular function
    • • Central venous pressure
    • Monitoring respiratory function
    • Temperature and renal function
  • Local anesthetics
  • • Pharmacology
    • Technique
    • Neuroanatomy
    • Technique for performing regional intraoral nerve blocks
    • • Middle mental nerve
      • Inferior alveolar nerve
      • Infraorbital nerve
      • Maxillary nerve
      • Major palatine foramen approach to the maxillary nerve
      • Local infiltration
• Postoperative care
• • Use of opioids for the maintenance of analgesia
  • • Oral administration
    • Transdermal administration
    • Local administration
  • Nonsteroidal antiinflammatory drugs (NSAIDs)
  • • Carprofen
    • Ketorolac
    • Ketoprofen
    • Etodolac
    • Meloxicam
    • Deracoxib
    • Firocoxib
    • Tepoxalin
  • Balanced analgesia
• References