Cumulative incidence of postoperative severe pain at Hospital Universitario San Jose, Popayan. Preliminar report
Abstract
Introduction: Postoperative pain remains as a problem. National studies report incidences of 31% for moderate and 22% for severe pain. Inadequate analgesia is related to dissatisfaction and adverse outcomes. The aim of this study was to describe the incidence and characteristics of the postoperative pain in the post-anesthesia care unit (PACU) at Hospital Universitario San José of Popayán (HUSJ) in patients undergoing general anesthesia during the first postoperative hour. Methods: Cohort study. We recruited patients attending PACU and undergoing procedures using general anesthesia, between 18 and 70 years. Using a standardized collection form medical history, demographic data, medical history, anesthetic management, intraoperative analgesia and postoperative pain assessment by verbal and numerical pain scale (1-10) were recorded. Postoperative outcome data were also collected in the PACU. Results: The incidence of severe postoperative pain at 10 minutes was 12.3% 95%CI [7.1-18.2] (19 patients). Within 30 minutes of assessment 4.5% 95%CI [1.3-8.4] (7 patients) and 1.9% 60 minutes 95%CI [0-4.5] (3 patients). 48.7% required rescue analgesic at PACU. Incidence of postoperative nausea and vomiting (PONV) was significantly different in patients requiring rescue analgesic. Conclusion: The incidence of severe postoperative pain in the first postoperative hour at HUSJ is close to 12% and it decreases as time goes by. Patients requiring rescue analgesic have a higher incidence of postoperative complications such as PONV.Downloads
References
Melzack R, Wall PD. Mediadores inflamatorios y moduladores del dolor. En: MacMahon S, Koltzenburg M. Tratado del Dolor. España: Elsevier; 2007. p. 49-72.
Cadavid AM, Mendoza JM, Gómez ND, Berrío MI. Prevalencia de dolor agudo posoperatorio y calidad de la recuperación en el Hospital Universitario San Vicente de Paúl, Medellín, Colombia 2007. Iatreia. 2009; 22(1):11-15.
García M, Muñoz J, Ferré F, Cantera M, Miralles F. Influencia de la U.D.A. en la evolución del postoperatorio tras toracotomía. Rev Esp Anestesiol Reanim. 2000;7:141-7.
Koshy RC, Kuriakose R. Acute postoperative Pain management: Patterns, Preferences and Problems. J Anaesthesiol Clin Pharmacol. 2004;20(3):263-266.
Macrae W. Chronic post-surgical pain: 10 years on. Br J Anaesth. 2008;101(1):77-86.
Pogatzki-Zahn EM, Zahn PK, Brennan TJ. Postoperative pain clinical implications of basic research. Best Practice & Research Clinical Anaesthesiology. 2007;21(1):3-13.
Martínez-Vázquez de Castro J, Torres LM. Prevalencia del dolor postoperatorio. Alteraciones fisiopatológicas y sus repercusiones. Rev Esp Anestesiol Reanim. 2000;7:465-76.
Gallego JI, Rodriguez de la Torre MR, Vázquez-Guerrero JC, Gil M. Estimation of the prevalence and severity of postoperative pain and relation with patient satisfaction. Rev Esp Anestesiol Reanim. 2004;11:197-202.
Miranda A. Dolor postoperatorio: definición y problemática. En: Miranda A. : Dolor posoperatorio. Estudio, valoración y tratamiento. Barcelona: Ed. Jims; 1992.p.1- 26.
Serlin RC, Mendoza TR, Nakamura Y, Edwards KR, Cleeland CS. When is cancer pain mild, moderate or revere? Grading pain severity by its interference with function. Pain. 1995;61(2):277-84.
Soler Company E, Faus Soler MT,- Montaner Abasolo MC. El dolor postoperatorio en la actualidad: un problema de calidad asistencial. Farmacia Hospitalaria. 2000;24(3):123-135.
Gerbershagen HJ, Aduckathil S, Van Wijck AJ, Peelen LM, Kalkman CJ, Meissner W. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013; 118(4):934-944.
Dolin SJ, Cashman JN, Bland JM. Effectiveness of acute postoperative pain management: I. Evidence from published data. Br J Anaesth. 2002;89:409-23.
Machado JE, Quintero AM, Mena MF, Castaño CA, López EM, et al. Evaluación del manejo del dolor postquirúrgico en pacientes adultos de una clínica de tercer nivel de Pereira, Colombia. Investigaciones Andina. 2012;14:547-559.
Cardona E, Castaño ML, Builes AM, Castro A. Manejo del dolor postquirúrgico en el Hospital Universitario San Vicente de Paul de Medellín. Rev Colomb Anestesiol. 2003;31(2):111-117.
Machado-Alba JE, Machado Duque ME, Calderón V, Gonzalez A, Cardona F, Ruis R, Montoya J. ¿Estamos controlando el dolor posquirúrgico? Rev Colomb Anestesiol. 2013;41(2):132–138.
Sarzosa RS, Cabrera R, Quintero I, Calvache JA. Revista Facultad de Ciencias de la Salud Universidad del Cauca. 2007;9(2):8-14.
Roberts GW, Bekker TB, Carlsen HH, Moffatt CH, Slattery PJ, McClure AF. Postoperative nausea and vomiting are strongly influenced by postoperative opioid use in a dose-related manner. Anesthesia & Analgesia. 2005;101(5):1343-1348.
Gómez-Arnau JI, Aguilar JL, Bovaira P, Bustos F, De Andrés J, de la Pinta JC. Postoperative nausea and vomiting and opioid induced nausea and vomiting: guidelines for prevention and treatment. Rev Esp Anestesiol Reanim. 2010:57(8):508-524.
McCambridge J, Witton J, Elbourne DR. Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol. 2014;67(3):267-77.
.png)
