Contradictions Between the Prevalence of Postoperative Pain and Pain Relief Satisfaction
DOI:
https://doi.org/10.32635/2176-9745.RBC.2000v46n1.3407Keywords:
Postoperative Pain, Pain Assessment, Pain Relief, Acute PainAbstract
Although postoperative pain is highly frequent, its management remains inadequate. Fifty-five oncologic patients who had undergone surgical procedures were assessed about their pain experience and satisfaction with pain relief. The results showed that 78,2% had experienced pain in the first 24 hours of postoperative period. The mean intensity was 5-6; 58.3% experienced moderate pain and 27,1% severe pain. The short-form of the McGill Pain Questionnarie adapted to the Portuguese language, noticed that the affective dimension of pain was prevailing. Sleep, rest and movimentation in bed were the daily life activities most affected by pain. Association between NSAIDs and opioids was the most frequent (57%) and 45.5% of analgesics were ordered in around-the-clock method exclusively. The proportion of prescribed and actually received drugs by patients was 92%) and 80%) for around-the clock and “as need”prescriptions respectively. The intravenous route was prescribed in 57.8% of the cases, followed by intramuscular route (25%). Despite the high incidence and intensity of pain and the repercussion in daily life activities, 74.4%) expressed satisfaction with their postoperative pain relief. This contradiction can be related with the belief that postoperative pain is inevitable.
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KITSON, A. Post-operative pain management: a literature review. J. Clin. Nurs., v.3, n.1, p. 7 - 18, 1994. DOI: https://doi.org/10.1111/j.1365-2702.1994.tb00353.x
MARTINS, L.M.M.; PIMENTA, C.A.de M. Dor e satisfação com a analgesia no pós-operatório. In: Simpósio Internacional da Dor, 3., São Paulo, 1997. Programa oficial. São Paulo, Simbidor, 1997, p.18-9.
PAICE, J.A.; MAHON, S.M.; CALLAHAN, M.F. Factors associated with adequate pain control in hospitalized postosurgical patients diagnosed with cancer. Cancer Nurs, v. 14, n.6, p.298 - 305, 1991. DOI: https://doi.org/10.1097/00002820-199112000-00003
PIMENTA, CA de M. et al. Don ocorrência e evolução no pós-operatório de cirurgia cardíaca e abdominal. Rev. Paul. Enf, v.ll, n.l, p.3-10, 1992.
READY, L.B.; EDWARDS, W.T. Tratamento da dor aguda. Rio de Janeiro, Revinter, 1997.
BONICA, J.J. The management of pain. 2.ed. Philadelphia/London, Lea & Febiger, 1990. v.l. cap.2, p. 18-27: Definitions and taxonomy of pain.
TEIXEIRA, M.J.; PIMENTA, C.A. de M. Síndromes dolorosas. Rev.Med., v.74, n.2, p. 65 -6, 1995.
BONICA, J.J. Anatomic and psysiologic basis of nocipetion and pain. The management of pain. 2.ed. Philadelphia/London, Lea & Febiger, 1990. v.l. cap.3, p.28-94.
BONICA, J.J.; YAKSH, T; LIEBESKIND, J.C.; PECHINICK, R.N.; DEPAULIS, A. Biochemestryand modulation of nociception and pain. In: BONICA, J.J. The management of pain. 2.ed. Philadelphia/London, Lea & Febiger, 1990. v.l. cap.4, p.95-121.
COELI, S.C.M. Modelo de tratamento de dor aguda pós-operatória, clínica e traumática. In: Simpósio Internacional da Dor, 3., São Paulo, 1997. Anais. São Paulo, Simbidor, 1997, p. 57-60.
JACKSON, A Acute pain: its physiology and the pharmacology ofanalgesia. Nurs. Times, v.91, n. 16, p.27-8,1995.
CLOSS, S.J. An exploratory analysis of nurses’ provision of postoperative analgesic drugs. J Adv Nurs, v. 15, n. 1, p.42 - 9, 1990. DOI: https://doi.org/10.1111/j.1365-2648.1990.tb01671.x
PIMENTA, C.A. de M. Escalas de avaliação de dor. In: TEIXEIRA, M.J. Dor: conceitos gerais. São Paulo, Limay, 1994.
PIMENTA, C.A. de M.; TEIXEIRA, M.J. Avaliação da dor. Rev.Med., v.76, n.1, p.27-35, 1997.
CARR, E.C.J. Postoperative pain: patients’ expectations and experiences. J. Adv. Nurs., v.15, n.1, p.89-100, 1990. DOI: https://doi.org/10.1111/j.1365-2648.1990.tb01677.x
DONAVAN, M.I.; DILON, P. Incidence and characteristics of pain in a sample of hospitalized cancer patients. Cancer Nurs, v.10, n.2, p.85 - 92, 1987. DOI: https://doi.org/10.1097/00002820-198704000-00005
TUCKER, C. Acute pain and substance abuse in surgical patients. J Neuroci Nurs, v.22, n.6, p. 339- 50, 1990. DOI: https://doi.org/10.1097/01376517-199012000-00003
UNITES STATES. U.S. Departament of Health and Human Services. Agency for Health Care Policy and Research. Acute pain management: operative and medical procedures and trauma. Rockville, AHCPR, 1992. (Clinical practice guideline, n. 1.)
DONAVAN, B.D. Patient attitudes to postoperative pain relief Anaesth. Intens. Care., v. 11, n.2, p. 125 - 9, 1983. DOI: https://doi.org/10.1177/0310057X8301100206
KUNN, S. et al. Perceptions of pain relief after surgery. BMJ, V. 300, n.6741, p.1687 -90, 1990. DOI: https://doi.org/10.1136/bmj.300.6741.1687
LYNCH, E.P. et al. Patient experience of pain after elective noncardiac surgery. Ancsth. Analg., v. 85, n.1, p. 117- 23, 1997. DOI: https://doi.org/10.1097/00000539-199707000-00021
OWEN, H.; McMILLAN, V.; ROGOWSKI, D. Postoperative pain therapy: a survey of patients’ expectations and their experiences. Pain, v.4l, n.3, p.303-7, 1990. DOI: https://doi.org/10.1016/0304-3959(90)90007-Z
OATES, J.D.L.; SNOWDON, S. L; JAYSON, D.WH. Failure of pain relief after surgery. Anaesthesia, v.49, n.9, p.755-8, 1994. DOI: https://doi.org/10.1111/j.1365-2044.1994.tb04444.x
SILVA, I.J. da C.; CHAMHIE JUNIOR, E; NOVO, N.E; JULIANO, Y; GOLDENBERG, S. Frequência da dor após a ligadura elástica de hemorróidas: estudo prospectivo e randomizado. Rev. Bras. Golo-Proct, v. 10, n.4, p. 134- 8, 1990.
HGSKISSON, E.C. Measurement of pain. Lancet, v.2, p. 1127- 31, 1974. DOI: https://doi.org/10.1016/S0140-6736(74)90884-8
PIMENTA, C.A. de M.; CRUZ, D. de A.L.M. da; SANTOS, J.L.E Instrumentos para avaliação de dor: o que há em nosso meio. Arq. Bras. Neurocir., São Paulo, v.17, n.1, p.15-24, 1998.
PIMENTA, C.A. de M. et al. Versão reduzida do questionário de dor McGill para Língua Portuguesa. In: Simpósio Internacional da Dor, 3., São Paulo, 1997. Programa oficial. São Paulo, SIMBIDOR, 1997, p. 26.
DAUT, R.L.; CLEEDLAND, C.S.; FLANERY, R.C. Developement of the Wisconsin Brief Pain Questionnaire to asses pain in cancer and other diseases. Pain, v. 17, n. 2, p. 197-210, 1983. DOI: https://doi.org/10.1016/0304-3959(83)90143-4
CLEELAND, C.S.; GONIN,R; HATFIELD, A.K.; EDMONSON, J.H.; BLUM, R.H.; STEWART, J.A.; PANDYA, K.J. Pain and its treatment in outpatients with metastatic cancer. N.Engl. J. Med., v.330, n.9, p. 592 -6, 1994. DOI: https://doi.org/10.1056/NEJM199403033300902
VALDIX, S.W.; PUNTILLO, K.A. Pain, pain relief and accuracy of their recall after cardiac surgery. Prog. Cardiovasc. Nurs., v.lO, n.3, p.3 - 11, 1995.
WASYLAK, TJ. Surgical pain management. In: WATT, J.H.W., DONAVAN, M.J. Pain management: nursing perspective. St Louis, Mosby Year Book, 1992. cap. 15, p. 401-25
MELZACK, R. The McGill pain questionnaire: major properties and scorin methods. Pain, v. 1, n.3, p.277-99, 1975. DOI: https://doi.org/10.1016/0304-3959(75)90044-5
PIMENTA, C.A. de M.; TEIXEIRA, M.J. Proposta de adaptação do questionário de dor McGill para a língua portuguesa. Rev. Esc. Enf USP, v.30, p.473-83, 1996. DOI: https://doi.org/10.1590/S0080-62341996000300009
WILKE, D.J.; SAVEDRA, M.C.; HOLZEMER, W.L.; TESLER, M.D.; PAUL, S.M. Use of the McGill Pain Questionnaire to measure pain: a meta-analysis. Nurs. Res., v. 39, n.1, p.36-41, 1990. DOI: https://doi.org/10.1097/00006199-199001000-00008
BENEDETTI, C.; BUTLER, S.H. Systemic analgesics. In: BONICA, J.J. The management of pain. 2.ed. Philadelphia/London, Lea & Febiger, 1990. v.2. cap.78, p.1640-75.
AMERICAN PAIN SOCIETY- Principies of analgesic use in the treatment of acute pain and cancer pain. 3 ed. Skokie, 1993.
MARKS, R.M.; SACHAR, E.J. Undertreatment of medical inpatients with narcotic analgesics. Ann. Intern. Med., V.78, n.2, p.173-81, 1973. DOI: https://doi.org/10.7326/0003-4819-78-2-173
PIMENTA, C.A. de M.; KOIZUMI, M.S.; TEIXEIRA, M.J. Dor no doente com câncer: características e controle. Rev. Bras. Cancerol., v.43, n.1, p.21-44, 1997. DOI: https://doi.org/10.32635/2176-9745.RBC.1997v43n1.2835
