PAIN MANAGEMENT IN THE PRIMARY CARE PRACTICE

摘要

In the primary care setting, our moral imperative is to advocate on behalf of a being who cannot advocate for itself. One of the most important manifestations of this obligation to our patients is the recognition, prevention, and relief of pain and suffering. Leon Bernard, a French physician from the 15th century said, "Medicine should be practiced as a form of friendship," and friends don't let friends hurt! In a primary care setting, a large number of patients present with some sort of pain issue.Our paradigm for pain in animals in the past was to look to the owner to report behavior changes or to assume the animal would cry out or, in some other way, make us certain they were painful. Likewise, until not that long ago, veterinarians were taughtthat pain was not that important in the perioperative period. In fact, veterinarians were taught that postoperative pain was a good thing because it meant that the animal would not move around much and so would put their surgical site at lower risk of acomplication. Now that pain management is an accepted part of mainstream veterinary practice, it would be absurd for a veterinary health care team member to presume that a postoperative patient "should" experience pain. It is likewise inappropriate for the veterinary health care team to wait until the client recognizes that the pet is in pain from a chronic disease like osteoarthritis.