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Objectifs : Évaluer la pratique de l'analgésie postopératoire et le niveau de connaissance des praticiens sur la douleur et sa prise en charge. Matériels et méthodes : Le cadre de notre étude est les services d'anesthésie-réanimation chirurgicale des centres hospitaliers départementaux et de l'hôpital de la mère et de l'enfant (HOMEL) du Bénin. Il s'agit d'une étude prospective et descriptive sur une période de sept mois (octobre 2004 à mai 2005). Une fiche d'enquête a servi de recueil des données et le dépouillement a été fait au moyen des logiciels Épi-info et SPSS.Résultats : Au total 347 patients ont été inclus. L'âge moyen était de 28 AE 6 ans. La césarienne était l'intervention la plus pratiquée (52 %) suivie des appendicectomies (18 %) et de la cure herniaire (15 %). L'anesthésie générale a été pratiquée dans 63 % des cas contre environ 37 % de rachianesthésie. Les infirmiers diplômés d'État (IDE) (62 %) étaient les premiers prescripteurs d'antalgiques suivis des chirurgiens (21 %) et des infirmiers spécialisés en anesthésie-réanimation (ISAR) (13 %). La plupart des prescriptions antalgiques étaient faites en réanimation (45 %) et au bloc opératoire (36 %). Les NVPO étaient les effets secondaires les plus observés (19,4 %). En fonction de l'échelle utilisée, entre 58 et 79 % des patients étaient douloureux à la quatrième heure postopératoire. Le degré de satisfaction des patients sur la prise en charge de leur douleur atteignait 38 % à la quatrième heure postopératoire. Les 39 praticiens interrogés avaient une faible connaissance des moyens d'évaluation de la douleur et de sa prise en charge.Abstract: Objective: To evaluate the practice of postoperative analgesia and level of expertise of practitioners in postoperative pain management.Material and methods: This seven-month prospective study (October 2004 to May 2005 took place in the anaesthesiology and intensive care units of the five department hospitals and Hôpital de la Mère et de l'Enfant (HOMEL) of Benin. A case report was completed for each patient.Results: The study included 347 patients, and their average age was 28 AE 6. The Caesarean section was the most frequently practiced surgical procedure (52 %), followed by appendectomies (18 %) and hernia repairs (15 %). General anaesthesia was administered in 63 % of the cases versus 37 % for spinal anaesthesia. The top prescribers were nurses (62 %), followed by surgeons (21 %) and nurses anaesthetists (13 %). Postoperative analgesics were most often prescribed in the intensive care unit (45 %), then the operating room (36 %). The incidence of postoperative nausea and vomiting was 19.4 %. According to the scale used, 58 to 79 % of patients experienced pain 4 hours after surgery. Patients were satisfied or very satisfied in 38 % of the cases 4 hours after surgery. The level of expertise in postoperative pain management of 39 practitioners was very low.
Objectifs : Évaluer la pratique de l'analgésie postopératoire et le niveau de connaissance des praticiens sur la douleur et sa prise en charge. Matériels et méthodes : Le cadre de notre étude est les services d'anesthésie-réanimation chirurgicale des centres hospitaliers départementaux et de l'hôpital de la mère et de l'enfant (HOMEL) du Bénin. Il s'agit d'une étude prospective et descriptive sur une période de sept mois (octobre 2004 à mai 2005). Une fiche d'enquête a servi de recueil des données et le dépouillement a été fait au moyen des logiciels Épi-info et SPSS.Résultats : Au total 347 patients ont été inclus. L'âge moyen était de 28 AE 6 ans. La césarienne était l'intervention la plus pratiquée (52 %) suivie des appendicectomies (18 %) et de la cure herniaire (15 %). L'anesthésie générale a été pratiquée dans 63 % des cas contre environ 37 % de rachianesthésie. Les infirmiers diplômés d'État (IDE) (62 %) étaient les premiers prescripteurs d'antalgiques suivis des chirurgiens (21 %) et des infirmiers spécialisés en anesthésie-réanimation (ISAR) (13 %). La plupart des prescriptions antalgiques étaient faites en réanimation (45 %) et au bloc opératoire (36 %). Les NVPO étaient les effets secondaires les plus observés (19,4 %). En fonction de l'échelle utilisée, entre 58 et 79 % des patients étaient douloureux à la quatrième heure postopératoire. Le degré de satisfaction des patients sur la prise en charge de leur douleur atteignait 38 % à la quatrième heure postopératoire. Les 39 praticiens interrogés avaient une faible connaissance des moyens d'évaluation de la douleur et de sa prise en charge.Abstract: Objective: To evaluate the practice of postoperative analgesia and level of expertise of practitioners in postoperative pain management.Material and methods: This seven-month prospective study (October 2004 to May 2005 took place in the anaesthesiology and intensive care units of the five department hospitals and Hôpital de la Mère et de l'Enfant (HOMEL) of Benin. A case report was completed for each patient.Results: The study included 347 patients, and their average age was 28 AE 6. The Caesarean section was the most frequently practiced surgical procedure (52 %), followed by appendectomies (18 %) and hernia repairs (15 %). General anaesthesia was administered in 63 % of the cases versus 37 % for spinal anaesthesia. The top prescribers were nurses (62 %), followed by surgeons (21 %) and nurses anaesthetists (13 %). Postoperative analgesics were most often prescribed in the intensive care unit (45 %), then the operating room (36 %). The incidence of postoperative nausea and vomiting was 19.4 %. According to the scale used, 58 to 79 % of patients experienced pain 4 hours after surgery. Patients were satisfied or very satisfied in 38 % of the cases 4 hours after surgery. The level of expertise in postoperative pain management of 39 practitioners was very low.
Anesthesia in developing countries deserves special attention. The most common technique is general anesthesia (with spontaneous or manually assisted ventilation). Nonmedical anesthetists with limited training and supervision and lacking the most common drugs and anesthetic equipment administer anesthesia, usually for emergency surgery. There are important safety issues, especially for pediatric anesthesia. Regarding pediatric surgery, the major workload is due to abdominal emergencies, mainly neonatal bowel obstruction or peritonitis due to typhoid perforation. The morbidity and mortality rate for these conditions is high.
Introduction: Pain is a frequent reason for consultation in health facilities. Thus, nurses are in the forefront in the fight against pain. The aim of this study was to determine the role of the nurse in the management of the painful adult patient. Methodology: It was a cross-sectional study conducted in 11 departments of Kara teaching hospital during two weeks. Nurses who had managed a painful adult in the past seven days were included in the study. Results: Thirty nurses participated in the study. They were made of 24 men (76.67%) and six women (23.33%). The average age of nurses was 35 years (extremes: 23 years old and 50 years old) and 43.33% of them had less than five years of work experience. The main etiologies of pain managed were: trauma (22%), headache (18%) and abdominal pain (14%). Pain assessment tools were almost non-existent. Fifty percent of nurses did not know pain assessment tools. The evaluation of pain was performed with conventional tools by 16% of nurses. The analogical visual scale was the most used (three out of five nurses). Nursing intervention was dominated by counseling (43%) and thermal stimulation (22%). The use of analgesics was carried out in 83.33% of cases. Conclusion: This study shows that few nurses evaluated the pain during its management in adults. Therefore, it is necessary to initiate medical training for Togolese nurses on the management of the painful patient in order to make them more effective.
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