This is due to metabolic, immunologic, or direct physical effects on the nervous system. It is difficult to control with standard analgesics. Fentanyl is no exception. Thus whenever possible, preventative therapy should be used as opposed to trying to suppress pain once it becomes a serious clinical problem. On the other hand, because fentanyl results in slow postoperative warming, parenteral administration of fentanyl and application of the patch shortly after surgery is often practiced.
Pain management begins with good quality compassionate care.
Careful nursing with gentle handling of the patient and providing an environment that is comfortable and relaxing are of great benefit. Local anesthesia should be employed whenever possible to alleviate local discomfort. Systemic analgesia should be employed whenever there is a possibility that the discomfort is not localized or cannot be treated with local analgesia. These drugs do not cause central nervous system toxicity because they work peripherally, but can cause gastrointestinal upset. Although they are quite effective, they are not perceived by owners as having a significant analgesic effect and therefore may be dismissed as useful drugs.