Women Suffer More Short and Long-term Pain Than Men After Major Thoracotomy

Ochroch, E. Andrew; Gottschalk, Alan; Troxel, Andrea B.; Farrar, John T.

doi:10.1097/01.ajp.0000208246.18251.f2

Cited by 84 publications

(58 citation statements)

References 35 publications

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“…A média de idade também se mostrou semelhante (40 anos versus 46 (2) ). Os dados do atual estudo indicam que a busca por serviços de saúde e a maior atenção à saúde ocorrem com maior frequência em pacientes do sexo feminino, fato também reportado na literatura (24) . Houve relação significativa entre o sexo e o diagnóstico/tipo de cirurgia (p<0,01) no presente estudo.…”

Section: Discussionunclassified

“…Esse fator pode apresentar significativa influência na intensidade da DPO (2,24,25) . Em hospitais generalistas, a cirurgia geral é a mais comum entre as especialidades cirúrgicas realizadas, seguida pelas ginecológica, proctológica, vascular e mastológica (2) .…”

Section: Discussionunclassified

“…A influência do sexo do paciente na DPO é também destacada em outros estudos (12,16,23,24) , em que normalmente se evidenciam uma maior prevalência para o sexo feminino, mas sob um único tipo de cirurgia e tendo em conta a possibilidade das mulheres verbalizarem a dor com mais facilidade e alegarem com mais facilidade a dor severa (2,16,24) . No presente estudo, houve associações significativas entre o sexo e local ou intensidade da dor, mas não com a prevalência.…”

Section: Discussionunclassified

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Dor pós-operatória em hospital universitário: perspectivas para promoção de saúde

Franco

Sugai

Silva

et al. 2017

RBPS

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Thaís de Carvalho da SilvaUniversidade José do Rosário Vellano -UNIFENAS -Alfenas -(MG) -Brasil Roberta Bessa Veloso SilvaUniversidade José do Rosário Vellano -UNIFENAS -Alfenas -(MG) -Brasil Roberto Salvador de Souza Guimarães Universidade José do Rosário Vellano -UNIFENAS -Alfenas -(MG) -Brasil Cláudio Daniel Cerdeira Universidade Federal de Alfenas -UNIFAL -Alfenas -(MG) -Brasil Gérsika Bittencourt SantosUniversidade José do Rosário Vellano -UNIFENAS -Alfenas -(MG) -Brasil RESUMOObjetivo: Avaliar a prevalência, os fatores influentes e a magnitude da dor pós-operatória (DPO) em pacientes atendidos em um hospital universitário. Métodos: Realizou-se estudo prospectivo e transversal envolvendo 100 pacientes submetidos a diferentes procedimentos cirúrgicos, no período de março a maio de 2016, entrevistados nas primeiras 24 horas do pós-operatório e avaliados através de uma escala visual numérica (EVN). Resultados: As cirurgias mais comuns encontradas são: cesárea, apendicectomia, prostatectomia, tireoidectomia total e osteossíntese; e as anestesias: raquianestesia e geral balanceada, sendo a prevalência de DPO menor quando usada a raquianestesia. Dos pacientes, 43% (n = 43) declararam DPO, com prevalência de 44% (n = 14) para o sexo masculino e 43% (n = 29) para o feminino. Entre esses, 30% (n = 13) classificaram a DPO como de intensidade forte, 53,5% (n = 23) classificaram como moderada, e 14% (n = 6), leve. Houve maior prevalência de DPO nas faixas etárias de 25-34 e 55-64 anos, e relações causais significativas entre o sexo do paciente e as variáveis diagnóstico, tipo de cirurgia, local ou intensidade da dor. Além disso, o local da DPO relacionou-se com a faixa etária ou tipo de cirurgia, e a intensidade se relacionou com a faixa etária. Conclusão: A dor pós-operatória no hospital universitário em questão se apresentou prevalente em pacientes de ambos os sexos e dependente da faixa etária, da heterogeneidade de procedimentos cirúrgicos e de protocolos anestésicos, sendo a de intensidade moderada a mais identificada.Descritores: Dor; Cirurgia Geral; Prevalência; Epidemiologia.

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Section: Discussionunclassified

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Dor pós-operatória em hospital universitário: perspectivas para promoção de saúde

Franco

Sugai

Silva

et al. 2017

RBPS

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“…There is no clear evidence to suggest sex predominance but it was observed that women tended to report higher levels of pain with concomitant use of simple analgesics. And younger patients reported more pain as compared to the elderly 19 . There is little consensus regarding the impact that the type of surgery has on the clinical outcome in terms of PTPS.…”

Section: Epidemiologymentioning

confidence: 94%

“…24,25,27,28 There is evidence to suggest a gender difference where women may be at a higher risk of developing post surgical pain. 19,28 Currently there is no definitive evidence to suggest that post thoracotomy pain has age or gender preponderance.…”

Section: Demographic Factorsmentioning

confidence: 99%

Post-Thoracotomy Pain Syndrome

Joseph¹,

Puttappa²,

Harney³

2012

Topics in Thoracic Surgery

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Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery

Andreae

2012

Cochrane Database of Systematic Reviews

102

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Background Regional anaesthesia may reduce the rate of persistent (chronic) pain after surgery, a frequent and debilitating condition. Objectives To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of persistent pain six or 12 months after surgery. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 4), PubMed (1966 to April 2012), EMBASE (1966 to May 2012) and CINAHL (1966 to May 2012) without any language restriction. We used a combination of free text search and controlled vocabulary search. The results were limited to randomized controlled clinical trials (RCTs). We conducted a handsearch in reference lists of included trials, review articles and conference abstracts. Selection criteria We included RCTs comparing local anaesthetics or regional anaesthesia versus conventional analgesia with a pain outcome at six or 12 months after surgery. Data collection and analysis Two authors independently assessed trial quality and extracted data, including information on adverse events. We contacted study authors for additional information. Results are presented as pooled odds ratios (OR) with 95% confidence intervals (CI), based on random-effects models (inverse variance method). We grouped studies according to surgical interventions. We employed the Chi2 test and calculated the I2 statistic to investigate study heterogeneity. Main results We identified 23 RCTs studying local anaesthetics or regional anaesthesia for the prevention of persistent (chronic) pain after surgery. Data from a total of 1090 patients with outcomes at six months and of 441 patients with outcomes at 12 months were presented. No study included children. We pooled data from 250 participants after thoracotomy, with outcomes at six months. Data favoured regional anaesthesia for the prevention of chronic pain at six months after thoracotomy with an OR of 0.33 (95% CI 0.20 to 0.56). We pooled two studies on paravertebral block for breast cancer surgery; the pooled data of 89 participants with outcomes at five to six months favoured paravertebral block with an OR of 0.37 (95% CI 0.14 to 0.94).The methodological quality of the included studies was intermediate. Adverse effects were not studied systematically and were reported sparsely. Clinical heterogeneity, attrition and sparse outcome data hampered the assessment of effects, especially at 12 months. Authors’ conclusions Epidural anaesthesia may reduce the risk of developing chronic pain after thoracotomy in about one patient out of every four patients treated. Paravertebral block may reduce the risk of chronic pain after breast cancer surgery in about one out of every five women treated. Our conclusions are significantly weakened by performance bias, shortcomings in allocation concealment, considerable attrition and incomplete outcome data. We caution that our evidence synthesis is based on only a few, small studies. More studies with high methodological quality, addre...

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Women Suffer More Short and Long-term Pain Than Men After Major Thoracotomy

Abstract: Women have a distinctly different pain experience than men after thoracic surgery and probably require novel and/or multimodal analgesic regimens to improve their comfort.

Cited by 84 publications

References 35 publications

Dor pós-operatória em hospital universitário: perspectivas para promoção de saúde

Dor pós-operatória em hospital universitário: perspectivas para promoção de saúde

Post-Thoracotomy Pain Syndrome

Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery

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