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Pain Management During Surgery

Reviewed by Peter Kintzer DVM, DACVIM on Tuesday, August 5, 2014
Posted May 14, 2014 in Dog Surgery A-Z

Dr. Phil Zeltzman is a traveling, board-certified surgeon in Allentown, PA. His website is He is the co-author of “Walk a Hound, Lose a Pound” (

Kelly Serfas, a Certified Veterinary Technician in Bethlehem, PA, contributed to this article.

Bailey the dog

Bailey, an eight-year-old Lab, had knee surgery today. Obviously, medical procedures like this could potentially be accompanied by pain, but you might be surprised by all of the techniques veterinarians utilize to keep dogs like Bailey comfortable. See if you can count the ways as I recount his story!

Pain relief before surgery
During the initial consultation, Bailey's veterinarian prescribed two pain medications to help out until the day of surgery. One drug was a non-steroidal, anti-inflammatory medication (NSAID), which fights pain indirectly by reducing irritation. The other drug was tramadol, which is strictly a pain killer and in the same family as morphine.

Pain relief on the morning of surgery
On the day of surgery, Bailey was dropped off at the clinic in the morning. An IV catheter was placed in his leg.  He received three different injectable pain medications though the catheter. Then he was hooked up to an IV bag that contained the same three pain medications. This is called a constant rate infusion (CRI).  The slow drip of a CRI delivered a steady flow of the three pain medications into Bailey's body.  A CRI has 3 important benefits:

  • It allows us to use much smaller doses of medications (decreasing potential side effects)
  • It prevents the need for multiple injections
  • It provides non-stop pain relief

Once he was relaxed enough, Bailey was brought into the treatment room, where an IV sedative was given. Then a tube was placed through his mouth into his wind pipe. Through the tube, a mixture of oxygen and anesthetic gas was delivered. The gas kept our patient asleep and provided pain relief.

An antibiotic and an NSAID were given IV. Then an epidural was administered into the spine (just like when a woman is about to deliver a baby). The epidural numbed Bailey’s back leg.

The leg was shaved and scrubbed; Bailey had an injection of a local pain medication directly into the knee (similar to what we get at the dentist to numb our teeth).

Bailey was moved to the operating room where he had knee surgery.

Pain relief after surgery
As Bailey woke up from a successful

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Dr. Phil Zeltzman is a board-certified veterinary surgeon and author. His traveling practice takes him all over Eastern Pennsylvania and Western New Jersey. You can visit his website at, and follow him at