Postoperative analgesia by non-specialists in pain

Abstract

BACKGROUND AND OBJECTIVES:Postoperative analgesia is often administered by the assistant physician non-specialist in pain management. This study aimed at evaluating the efficacy of immediate postoperative period analgesia with drugs prescribed by the assistant physician, non-specialist in pain. METHODS: This is a prospective, descriptive and observational study carried out by means of interviews with 186 patients operated in Hospital Santa Cruz. Postoperative pain was evaluated after 12 and 24 hours, in addition to drugs used and possible adverse effects. RESULTS: In the first evaluation, 12 hours after surgery, prevalence of pain was 59%, being 35% from moderate to severe. In the second evaluation, 24 hours after surgery, prevalence of pain was 22% being 12% from moderate to severe. Variables "type of surgery" and "drugs used" have not influenced pain intensity in the postoperative period of 12 hours. However, "type of surgery" has influenced pain intensity (p=0.02) in the postoperative period of 24 hours, being that patients submitted to orthopedic procedures were more likely to report pain (49.57%) as compared to other types of surgery. Opioids had significant association with the presence of adverse effects in the first evaluation (p=0.0001). CONCLUSION: Our data have shown that analgesia with drugs prescribed by physicians non-specialists in pain management was effective when compared to other studies not using specialized pain services. However, a multimodal approach to acute pain management, coordinated by a specialized service, could further decrease this prevalence.

Influence of socio-demographic, clinical and surgical variables on the Aldrete-Kroulik Scoring System

“…As for analgesia, corroborating the present investigation, a study with the objective to evaluate the intensity of pain in 351 patients in the postoperative period showed that 98.9% of them received analgesia in the operating room (11) . Regarding postoperative analgesia, a study that included 186 patients also obtained similar results (17) . It may be noted that analgesia has been carried out according to WHO's recommendation, which advocate multimodal analgesia, with administration of various types of analgesic drugs (18) .…”

“…As for the influence of pain on the Aldrete-Kroulik Scoring System, this study found a statistically significant relationship, showing that the lower the intensity of pain, the higher the system's scores. Despite pain not being covered by the AKSS, it is expected to result in possible physiological changes that may interfere with the system's scores (17) .…”

Uso dos anti-inflamatórios não esteroides no controle da dor aguda

“…No aspecto segurança, verificou-se que os AINEs foram considerados seguros em 56,25% dos artigos selecionados, isoladamente ou em associação com os analgésicos opioides. Quando associados aos opioides, alguns efeitos adversos foram encontrados em maior proporção, como prurido, retenção urinária, náusea e, pelo menos um episódio de vômito [10][11][12][13][14][15] .…”

Acupuncture for postoperative pain in laparoscopic surgery: a systematic review protocol

“… 9 10 Although the type of surgery may influence the pain site and intensity, both reviews included multiple surgery types such as abdominal, lumbar or dental surgery as well as laparoscopic surgery. 31 Moreover, the definition of acupuncture used in those studies is either too broad, including multiple types of acupuncture point stimulation such as acupressure and transcutaneous electrical acupoint stimulation, 9 or too narrow, only focusing on ear acupuncture. 10 Therefore, we will evaluate postoperative pain induced by laparoscopic surgery and define acupuncture treatment adequately as two components: (1) needling with penetration of the skin and (2) on specific points including traditional acupuncture points or painful points around the incision or shoulder region.…”