Dor pós-operatória em pacientes submetidos à craniotomia eletiva

Abstract

RESUMO Objetivo: Identificar a presença de dor em pacientes submetidos à craniotomia eletiva e a localização dela. Método: Pesquisa descritiva, longitudinal com abordagem quantitativa. A casuística constituiu-se de 92 pacientes submetidos à craniotomia eletiva. Resultados: Os dados demonstram que 60,9% dos pacientes eram do sexo feminino, 56,5%, solteiros e 34,8%, oriundos da capital. No primeiro dia pós-operatório 63% dos pacientes queixavam-se de dor, e a cefaleia foi a principal queixa em 39,1% dos entrevistados. Constatou-se que 23,9% dos pacientes apresentavam dor intensa no primeiro dia pós-cirurgia. Em 6,5% dos entrevistados, a dor intensa persistia até o oitavo dia pós-cirurgia. A posição foi o fator agravante da dor em 10,9% dos pacientes no primeiro dia pós-operatório. Conclusão: A dor esteve presente na maioria dos pacientes submetidos à craniotomia eletiva, e a cefaleia foi a principal queixa dolorosa, caracterizada como moderada a intensa. O manejo adequado da dor não deve ser negligenciado, tendo em vista que o controle da dor é um direito do paciente. ABSTRACT Prevalence of pain in the postoperative of elective craniotomy Objective: To Identify the presence of pain in patients undergoing craniotomy and its location. Method: Descriptive, longitudinal research with a quantitative approach was performed. The series consisted of 92 patients undergoing elective craniotomy. Results: 60.9% of patients were female, 56.5% single, 34.8% originated from the capital city. On the first postoperative day 63% of patients complained of pain and migraine was the main complaint in 39.1% of the interviewees. It was found that 23.9% of patients had severe pain on the first day after surgery. In 6.5% of the interviewees, the intense pain persisted until the eighth day after surgery. The position was the aggravating factor of pain in 10.9% of patients in the first postoperative day. Conclusion: The pain was present in most patients undergoing craniotomy, and the main complaint was the migraine pain, characterized as moderate to severe. Proper handling of pain should not be neglected, once pain control is a patient's right.

Dor e analgesia pós-operatória: análise dos registros em prontuários

“…It was also indentified that most medical charts had no records on pain intensity by the multidisciplinary team, thus confirming our findings. When pain was recorded, in most cases this was done by physicians and in few patients by the nursing team 9 . It is known that in clinical practice opioids and NSAIDS are broadly used to treat and relieve POP, however their analgesic efficacy varies according to potency, duration of their effect and possibility of inducing undesirable effects which limit their continuity.…”

Pain in patients undergoing appendectomy

“…It was identified that 90.2% of cases had no pain recording, and the few existing records were made by physicians. A study evaluating pain in patients submitted to craniotomy has identified similar data 15 . Adequate pain evaluation and recording are critical to prevent surgical complications and patients' distress.…”

Preoperative headache in patients submitted to unrupted brain aneurysm clamping

“…The history of previous surgeries may trigger anxiety and, consequently, reflect in increased preoperative pain intensity 12 . Pain worsening brings several damages to patients, such as increased heart work, decreased blood offering to tissues and increased distress 13 , which may also be noxious for patients' clinical recovery.…”

“…Most patients had preoperative moderate, pulsing and frontal headache. Studies evaluating the prevalence of pain in patients submitted to craniotomy had high frequency of preoperative pain with similar characteristics [8][9][10][11][12][13][14] . The presence of aneurysm might have influenced pain pulsing character and frontal location.…”

“…Prophylactic administration of analgesics in a systematic manner is critical to maintain patients' hemodynamic balance and to assure effective neurosurgical recovery. It should be highlighted that pain control is patients' right which should be assured aiming at preventing noxious effects of pain, thus assuring adequate assistance 13 .…”