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Analgesia Combinations for Common Surgical Procedures with Dr. Kruse-Elliott

Kris Kruse-Elliott, DVM, PhD, DACVAA, SAGE Veterinary Centers, Redwood City, California

In this episode, host Alyssa Watson, DVM, is joined by Kris Kruse-Elliott, DVM, PhD, DACVAA, to talk about her recent Clinician’s Brief article, “Top 5 Analgesia Combinations for Common Surgical Procedures.” Dr. Kruse-Elliott takes what we already have in the clinic—opioids, NSAIDs, local anesthetics, ketamine, and dexmedetomidine—and explains how we can get them to join forces. She also shares useful details about how she puts these drugs to work in her own cases, including dosing, timing, and how oral medications fit in.

Key Takeaways

  • Full mu-opioid agonists provide the best analgesia (e.g., morphine, hydromorphone, fentanyl, methadone).
  • Injectable and OTM buprenorphine works well in cats; it can also be useful in dogs but high dosing volumes and cost can be limiting factors.
  • Reserving NSAIDs until post-op avoids the potential risk of nephrotoxicity related to anesthetic hypotension.
  • Low doses of dexmedetomidine or ketamine given intra-op can provide an analgesic boost that helps maintain depth without having to turn up the inhalant.
  • Incorporate local anesthesia as often as possible.
  • Oral analgesic options are limited; oral opioids and gabapentin aren’t good post-op analgesic options.

About Our Guest

Kris Kruse-Elliott, DVM, PhD, DACVAA, is an anesthesiologist at SAGE Veterinary Centers in Redwood City, California, and an anesthesia and analgesia consultant for Veterinary Information Network. Dr. Kruse-Elliott earned her DVM from Oregon State University. She also completed an anesthesia residency and NIH postdoctoral fellowship and earned a PhD in pulmonary physiology from North Carolina State University. She served as president of the North American Veterinary Anesthesia Society from 2019 to 2021. Her clinical interests are in heart and lung physiology and safe use of anesthesia in patients with cardiopulmonary disease.

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The Team:

  • Alyssa Watson, DVM - Host
  • Alexis Ussery - Producer & Digital Content Coordinator
  • Randall Stupka - Podcast Production & Sound Editing
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