Beyond Fentanyl: Why I’m All in on Multimodal Pain Management

And why more vets across Brisbane, the Sunshine Coast, and the Gold Coast are making the shift

You know the moment. The theatre is calm but focused, the monitors are steady, the team’s hands move with practised rhythm, and then there is the change. Heart rate ticks upward. Blood pressure creeps. And without thinking, your fingers reach for the fentanyl.

It’s reflexive. It was mine, too.

There’s a kind of comfort in the known, especially when your day’s already at a gallop. When your afternoon list is stacked and a post-op call is waiting, reaching for the familiar feels smart. Fentanyl is quick, effective, and it’s got our backs, until it doesn’t.

Over time, that reflex started to itch. Quietly, persistently, I found myself wondering:

Is this still the best we can offer?

What happens when we stop firefighting and start planning for pain

I’ve worked in veterinary anaesthesia across Brisbane, the Sunshine Coast and the Gold Coast for years. I know the effort, the care, and the corners we cut when time gets tight.

Multimodal pain management isn’t about abandoning what works. It’s about broadening the horizon, moving from “good enough” to truly excellent, with a plan that’s as thoughtful as the surgery itself.

Because when you prevent pain instead of reacting to it, something fundamental shifts. The energy in the room feels different. Your patient is steadier. Your decisions are sharper. You’re no longer playing catch-up; you’re one step ahead.

Fentanyl has earned its place. It’s potent, fast, and reliable, a workhorse in high-stakes moments. But it’s also become our fallback. And when fallback becomes first-line, we stop questioning whether something better is possible.

I started noticing the signs: erratic recoveries, breath-by-breath monitoring stress, and protocols that felt the same, regardless of whether the patient was a geriatric greyhound or a bouncy young kelpie.

What used to feel like control started to feel like chasing my tail.

That’s when I started leaning into alternatives. Not because fentanyl stopped working, but because there was something better waiting when I used it more sparingly, and far more strategically.

Layered care. Cleaner recoveries. Fewer surprises.

Multimodal pain management means dividing the workload. You target different pain pathways with complementary tools, so no single drug must do all the heavy lifting.

You block pain where it starts, dampen it centrally, support it peripherally, and reduce reliance on opioids that ask more of your patient than they give in return.

It’s not about complexity. It’s about clarity.

When a brachial plexus block reduces systemic drug needs by 60–70%, that’s not niche. That’s a shift in how you practise. Add in low-dose ketamine to block central sensitisation. Alpha-2s like dexmedetomidine to lower MAC and smooth your plane. NSAIDs where appropriate. Gabapentinoids when neuropathic pain is on the table.

It’s calm, layered, and far less reactive.

This isn’t just about smoother numbers on a screen. It’s about what happens when nobody’s holding their breath.

Your nurse isn’t split between pulse ox and prep. Your surgeon doesn’t have to pause for top-ups or guesswork. And you, the anaesthetist, can breathe. Observe. Think. Adapt. It brings a stillness to the work that’s hard to describe, but unmistakable once you feel it.

It lifts pressure off the team, shortens recoveries, and gives your patient the quiet, steady ride they deserve.

This is especially true in high-volume clinics around Brisbane and coastal QLD. Predictability becomes priceless when the margin for error is slim, and expectations are high.

Need a second pair of eyes on a pain plan? Want full support for a high-stakes case?
Contact The Anaesthesia Vet for your clinic’s board-certified, mobile specialist anaesthesia services. This way, you can stay present, focused, and operating at your best.

Because better outcomes start before the first incision, and sometimes, the right support makes all the difference.