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Determining The Incidence of Postsurgical Pain and Amount of Analgesic Use Postsurgical Pain and Analgesic

Year 2016, Issue: 2, 89 - 95, 01.06.2016

Kadriye Acar Hüseyin Acar Figen Demir Fatma Eti Aslan

Abstract

Objectives: Worldwide, surgical patients frequently complain about post-operative pain. Despite improvements in pharmacology and technology, post-operative pain still remains an important problem. This descriptive study was conducted in a surgery clinic to determine patients’ pain incidence, analgesic use and related factors. Patients and Methods: Our research was conducted between 01.09.2012-01.01.2013 in the general surgery clinic of Kocaeli University Research and Training Hospital. Patients who had undergone abdominal surgical operation and on post-operative day two were included in the study. One hundred and fifty patients agreed to participate. A quantitative evaluation scale was used to determine patients’ pain levels. A researcher interviewed each patient individually, and the data was recorded in the research paper. Results: According to the findings in our study 77.3% of patients had varying levels of pain and 22.7% did not have any pain. There was no relationship between pain and personal demographics, previous surgery or pain from different locations. We also found that 3% of patients did not use any analgesics, 78% of patients used only opioids and the remainder used NSAID, opioid or acetaminophen paracetamol alone or combined intravenously. Conclusion: In conclusion postoperative pain is founded to have a high incidence despite new and proven analgesia. Nurses should follow current approaches in the treatment of pain and should utilize other disciplines in order to use effective methods of pain management.

Keywords

Postoperative pain analgesic drugs pain management

References

  • Güneş Y, Işık G. Postoperatif ağrı tedavisinde siklooksijenaz-2 inhibitörleri. Ağrı 2004;16:7-16.
  • Eti-Aslan F. Ağrı Epidemiyolojisi. Ağrı Doğası ve Kontrolü, 2006;4:159-90.
  • Vadivelu N, Whitney CJ, Sinatra RS. Pain Pathways and Acute Pain Processing. Pain Physiology and Pharmacology. In Acute Pain Management. (Eds) Sinatra RS, Leon-Cassasola OA, Ginsberg B, Viscusi ER. New York, Cambridge University Press, 2009, p. 3-20.
  • Kılıç M, Öztunç G. Agrı Kontrolünde Kullanılan Yöntemler ve Hemsirenin RolüFırat Saglık Hizmetleri Dergisi 2012;7: 36-51.
  • Faydalı S. Cerrahi hastalarında analjeziklerin kaliteli kullanımı. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Dergisi 2010; 17:83-91.
  • Cambitzi J, Harries M, Raders EV. Postoperative Pain Management. İn Surgical Nursing Practice. Manley K, Bellman L (Eds). Churchill Livingstone, Edinburgh, 2000, p.466-506.
  • Özveren H. Ağrı Kontrolünde Farmakolojik Olmayan Yöntemler. Sağlık Bilimleri Fakültesi Hemşirelik Dergisi 2011;83-92.
  • Ay F, Alpar E. Postoperatif ağrı ve hemşirelik uygulamaları. AĞRI 2010;22: 21-9.
  • Royal College of Surgeons and College of Anaesthetists. Commission on the provision of surgical services report of the working party on pain after surgery. London, 1990, p. 5-8.
  • Wu CL, Raja SN. Treatment of acute postoperative pain. Lancet 2011;377:2215-25.
  • Couceiro TCM, Valença MM, Lima LC, Menezes TC, Raposo MCF. Prevalence and influence of gender, age, and type of surgery on postoperative pain. Rev Bras Anestesiol 2009;59:314-20.
  • Mattila K, Toivonen J, Janhunen L, Rosenberg PH, Hynynen M. Postdischarge symptoms after ambulatory surgery: First week incidence, intensity, and risk factors. Anesth Analg 2005; 101:1643-50.
  • Liu SS, Buvanendran A, Rathmell JP, Sawhney M, Bae JJ, Moric M et al. Predictors for moderate to severe acute postoperative pain after total hip and knee replacement. Int Orthop 2012; 36:2261-67.
  • Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a National survey suggest postoperative pain continues to be undermanaged. Anesth Analg 2003;97:534-40.
  • İzveren AÖ, Dal Ü. Abdominal cerrahi girişim uygulanan hastalarda görülen erken dönem sorunları ve bu sorunlara yönelik hemşirelik uygulamaları. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Dergisi 2011;18:36-46.
  • Aubrun F, Salvi N, Coriat P, Riou B. Sex and age-related differences in morphine requirements for postoperative pain relief. Anesthesiology 2005; 03:156-60.
  • Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL. Sex, gender, and pain: A review of recent clinical and experimental findings. J Pain 2009;10:447-85.
  • Gramke HF, de Rijke JM, van Kleef M, Kessels AG, Peters ML, Sommer M et al. Predictive factors of postoperative pain after day case Surgery. Clin J Pain 2009;25:455-60.
  • Bisgaard T, Klarskov B, Rosenberg J, Kehlet H. Characteristics and prediction of early pain after laparoscopic cholecystectomy. Pain 2001;90:261-69.
  • Caumo W, Schmıdt AP, Schneider CN, Bergmann J, Iwamoto CW, Adamatti LC et al. Preoperative predictors of moderate to intense acute postoperative pain in patients undergoing abdominal surgery. Acta Anaesthesiol Scand 2002;46:1265-71.
  • Schnabel A, Poepping DM, Gerss J, Zahn PK, Pogatzki-Zahn EM. Sex related differences of patient controlled epidural analgesia for postoperative pain. Pain 2012;153:238-44
  • Chia YY, Chow LH, Hung CC, Liu K, Ger LP, Wang PN: Gender and pain upon movement are associated with the requirements for postoperative patient-controlled iv analgesia: A prospective survey of 2.298 Chinese patients. Can J Anaesth 2002;49:249-55.
  • Eti-Aslan F. Postoperatif ağrı yaşlıların kaderi mi? Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi 2003;6:57-66.
  • Prowse M. Postoperative pain in older people: A review of the literature. J Clin Nurs 2006;16:84-97.
  • Coldrey JC, Upton RN, Macintyre PE. Advances in analgesia in the older patient. Best Pract Res Clin Anaesthesiol 2011;25:367-78.
  • Türk Anesteziyoloji ve Reanimasyon Derneği. Anestezi Uygulama Kılavuzları. Postoperatif Ağrı Tedavisi. 2006, s. 2-18.
  • Gagliese L, Katzu J. Age differences in postoperative pain are scale dependent: a comparison of measures of pain intensity and quality in younger and older surgical patients. Pain 2003;103:11-20.
  • Chung F, Ritchie E, Su J. Postoperative pain in ambulatory surgery. Anesth Analg 1997;85:808-16.
  • Lau H, Patil NG. Acute pain after endoscopic totally extraperitoneal (TEP) inguinal hernioplasty: multivariate analysis of predictive factors. Surg Endosc 2004 Jan;18:92-6.
  • Gagliese L, Gauthier LR, Macpherson AK, Jovellanos M, Chan VW. Correlates of postoperative pain and intravenous patient-controlled analgesia use in younger and older surgical patients. Pain Med 2008;9:299-314.
  • Lamacraft G. The link between acute postoperative pain and chronic pain syndromes. South Afr J Anaesth Analg 2012;18:45-50.
  • Taylor A, Stanbury L. A review of postoperative pain management and the challenges. Current Anaesthesia & Critical Care 2009;20:188-94.
  • Werner MU, Mjöbo HN, Nielsen PR, Rudin A. Prediction of postoperative pain: a systematic review of predictive experimental pain studies. Anesthesiology 2010;112:1494-502.
  • Aubrun F, Valade N, Coriat P, Riou B. Predictive factors of severe postoperative pain in the postanesthesia care unit. Anesth Analg 2008;106:1535-41.
  • Menteş Ö, Harlak A, Eryılmaz M, Balkan M, Kozak O, Arslan İ et al. Laparoskopik kolesistektomi sonrası ağrı tedavisinde tramadolün devamlı infüzyon ve hasta kontrollü analjezi ile uygulanmasının karşılaştırılması. Gülhane Tıp Dergisi 2009;51:6-10.
  • Elia N, Lysakowski C, Tramer MR. Does multimodal analgesiawith acetaminophen, and patient controlled analgesia morphine offer advantages over morphine alone? Meta analyses of randomized trials. Anesthesiology 2005;103:1296-304.
  • Pergolizzi JV Jr, van de Laar M, Langford R, Mellinghoff HU, Merchante IM, Nalamachu S et al. Tramadol/paracetamol fixed dose combination in the treatment of moderate to severe pain. J Pain Res 2012;5:327-46.
  • Wilder-Smith CH, Hill L, Dyer RA, Torr G, Coetzee E. Postoperative sensitization and pain after cesarean delivery and the effects of single im doses of tramadol and diclofenac alone and in combination. Anesth Analg 2003;97:526-33.
  • American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anest 2012;116:248-73.
  • Moizo E, Berti M, Marchetti C, Deni F, Albertin A, Muzzolon F, Antonino A. Acute Pain Service and multimodal therapy for postsurgical pain control: evaluation of protocol efficacy. Minerva Anestesiol 2004;70:779-87.

Cerrahi Sonrası Ağrı Insidansı ve Analjezik Kullanım Miktarının Belirlenmesi

Year 2016, Issue: 2, 89 - 95, 01.06.2016

Kadriye Acar Hüseyin Acar Figen Demir Fatma Eti Aslan

Abstract

Amaç: Cerrahi ağrı tüm dünyada hastaların sıklıkla şikayetçi olduğu bir durumdur. Son yıllarda farmakoloji ve teknoloji alanında kaydedilen tüm gelişmelere rağmen cerrahi ağrı hala ciddi bir sorun olmaya devam etmektedir. Bu araştırma bir cerrahi kliniğinde hastaların ağrı insidansını ve analjezik kullanımını belirlemek amacıyla yapıldı. Hastalar ve Yöntem: Araştırma 01.09.2012-01.01.2013 tarihleri arasında Kocaeli Üniversitesi Araştırma ve Uygulama Hastanesi genel cerrahi kliniğinde yatan ve abdominal cerrahi girişim geçirmiş, cerrahi sonrası ikinci günde olan araştırmaya katılmayı kabul eden 150 hasta ile gerçekleştirildi. Hastaların ağrı düzeylerini ölçmek için sayısal değerlendirme ölçeği kullanıldı. Veriler yüz yüze görüşme yöntemiyle toplanıp araştırmacı tarafından veri toplama formuna kayıt edildi. Bulgular: Araştırma sonucunda hastaların %77.3’ünün farklı derecelerde ağrısı olduğu, %22.7’sinin hiç ağrısı olmadığı bulundu. Hastaların bireysel özellikleri, önceki cerrahi bulguları ve başka yerde ağrı bulguları ile cerrahi ağrı arasında ilişki saptanmadı. Hastaların %3’ünün hiçbir analjezik almadığı, %78’inin sadece opioid türü analjezik aldığı geri kalan hastalara da opioid, non streoit anti inflamatuar ilaç NSAİİ ve asetominofen parasetamol ’in tekli veya kombine şekilde intravenöz IV yoldan uygulandığı belirlendi. Sonuç: Cerrahi ağrı insidansının yüksek olduğu, yeni ve kanıtlanmış ağrı giderme tekniklerinin varlığına rağmen bunlardan yeterince faydalanılmadığı görüldü. Hemşireler ağrı tedavisinde güncel yaklaşımları takip etmeli, etkin ağrı tedavisi yöntemlerini kullanmak amacıyla diğer disiplinleri harekete geçirmelidir.

Keywords

Postoperatif ağrı analjezik ilaçlar ağrı tedavisi

References

  • Güneş Y, Işık G. Postoperatif ağrı tedavisinde siklooksijenaz-2 inhibitörleri. Ağrı 2004;16:7-16.
  • Eti-Aslan F. Ağrı Epidemiyolojisi. Ağrı Doğası ve Kontrolü, 2006;4:159-90.
  • Vadivelu N, Whitney CJ, Sinatra RS. Pain Pathways and Acute Pain Processing. Pain Physiology and Pharmacology. In Acute Pain Management. (Eds) Sinatra RS, Leon-Cassasola OA, Ginsberg B, Viscusi ER. New York, Cambridge University Press, 2009, p. 3-20.
  • Kılıç M, Öztunç G. Agrı Kontrolünde Kullanılan Yöntemler ve Hemsirenin RolüFırat Saglık Hizmetleri Dergisi 2012;7: 36-51.
  • Faydalı S. Cerrahi hastalarında analjeziklerin kaliteli kullanımı. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Dergisi 2010; 17:83-91.
  • Cambitzi J, Harries M, Raders EV. Postoperative Pain Management. İn Surgical Nursing Practice. Manley K, Bellman L (Eds). Churchill Livingstone, Edinburgh, 2000, p.466-506.
  • Özveren H. Ağrı Kontrolünde Farmakolojik Olmayan Yöntemler. Sağlık Bilimleri Fakültesi Hemşirelik Dergisi 2011;83-92.
  • Ay F, Alpar E. Postoperatif ağrı ve hemşirelik uygulamaları. AĞRI 2010;22: 21-9.
  • Royal College of Surgeons and College of Anaesthetists. Commission on the provision of surgical services report of the working party on pain after surgery. London, 1990, p. 5-8.
  • Wu CL, Raja SN. Treatment of acute postoperative pain. Lancet 2011;377:2215-25.
  • Couceiro TCM, Valença MM, Lima LC, Menezes TC, Raposo MCF. Prevalence and influence of gender, age, and type of surgery on postoperative pain. Rev Bras Anestesiol 2009;59:314-20.
  • Mattila K, Toivonen J, Janhunen L, Rosenberg PH, Hynynen M. Postdischarge symptoms after ambulatory surgery: First week incidence, intensity, and risk factors. Anesth Analg 2005; 101:1643-50.
  • Liu SS, Buvanendran A, Rathmell JP, Sawhney M, Bae JJ, Moric M et al. Predictors for moderate to severe acute postoperative pain after total hip and knee replacement. Int Orthop 2012; 36:2261-67.
  • Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a National survey suggest postoperative pain continues to be undermanaged. Anesth Analg 2003;97:534-40.
  • İzveren AÖ, Dal Ü. Abdominal cerrahi girişim uygulanan hastalarda görülen erken dönem sorunları ve bu sorunlara yönelik hemşirelik uygulamaları. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Dergisi 2011;18:36-46.
  • Aubrun F, Salvi N, Coriat P, Riou B. Sex and age-related differences in morphine requirements for postoperative pain relief. Anesthesiology 2005; 03:156-60.
  • Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL. Sex, gender, and pain: A review of recent clinical and experimental findings. J Pain 2009;10:447-85.
  • Gramke HF, de Rijke JM, van Kleef M, Kessels AG, Peters ML, Sommer M et al. Predictive factors of postoperative pain after day case Surgery. Clin J Pain 2009;25:455-60.
  • Bisgaard T, Klarskov B, Rosenberg J, Kehlet H. Characteristics and prediction of early pain after laparoscopic cholecystectomy. Pain 2001;90:261-69.
  • Caumo W, Schmıdt AP, Schneider CN, Bergmann J, Iwamoto CW, Adamatti LC et al. Preoperative predictors of moderate to intense acute postoperative pain in patients undergoing abdominal surgery. Acta Anaesthesiol Scand 2002;46:1265-71.
  • Schnabel A, Poepping DM, Gerss J, Zahn PK, Pogatzki-Zahn EM. Sex related differences of patient controlled epidural analgesia for postoperative pain. Pain 2012;153:238-44
  • Chia YY, Chow LH, Hung CC, Liu K, Ger LP, Wang PN: Gender and pain upon movement are associated with the requirements for postoperative patient-controlled iv analgesia: A prospective survey of 2.298 Chinese patients. Can J Anaesth 2002;49:249-55.
  • Eti-Aslan F. Postoperatif ağrı yaşlıların kaderi mi? Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi 2003;6:57-66.
  • Prowse M. Postoperative pain in older people: A review of the literature. J Clin Nurs 2006;16:84-97.
  • Coldrey JC, Upton RN, Macintyre PE. Advances in analgesia in the older patient. Best Pract Res Clin Anaesthesiol 2011;25:367-78.
  • Türk Anesteziyoloji ve Reanimasyon Derneği. Anestezi Uygulama Kılavuzları. Postoperatif Ağrı Tedavisi. 2006, s. 2-18.
  • Gagliese L, Katzu J. Age differences in postoperative pain are scale dependent: a comparison of measures of pain intensity and quality in younger and older surgical patients. Pain 2003;103:11-20.
  • Chung F, Ritchie E, Su J. Postoperative pain in ambulatory surgery. Anesth Analg 1997;85:808-16.
  • Lau H, Patil NG. Acute pain after endoscopic totally extraperitoneal (TEP) inguinal hernioplasty: multivariate analysis of predictive factors. Surg Endosc 2004 Jan;18:92-6.
  • Gagliese L, Gauthier LR, Macpherson AK, Jovellanos M, Chan VW. Correlates of postoperative pain and intravenous patient-controlled analgesia use in younger and older surgical patients. Pain Med 2008;9:299-314.
  • Lamacraft G. The link between acute postoperative pain and chronic pain syndromes. South Afr J Anaesth Analg 2012;18:45-50.
  • Taylor A, Stanbury L. A review of postoperative pain management and the challenges. Current Anaesthesia & Critical Care 2009;20:188-94.
  • Werner MU, Mjöbo HN, Nielsen PR, Rudin A. Prediction of postoperative pain: a systematic review of predictive experimental pain studies. Anesthesiology 2010;112:1494-502.
  • Aubrun F, Valade N, Coriat P, Riou B. Predictive factors of severe postoperative pain in the postanesthesia care unit. Anesth Analg 2008;106:1535-41.
  • Menteş Ö, Harlak A, Eryılmaz M, Balkan M, Kozak O, Arslan İ et al. Laparoskopik kolesistektomi sonrası ağrı tedavisinde tramadolün devamlı infüzyon ve hasta kontrollü analjezi ile uygulanmasının karşılaştırılması. Gülhane Tıp Dergisi 2009;51:6-10.
  • Elia N, Lysakowski C, Tramer MR. Does multimodal analgesiawith acetaminophen, and patient controlled analgesia morphine offer advantages over morphine alone? Meta analyses of randomized trials. Anesthesiology 2005;103:1296-304.
  • Pergolizzi JV Jr, van de Laar M, Langford R, Mellinghoff HU, Merchante IM, Nalamachu S et al. Tramadol/paracetamol fixed dose combination in the treatment of moderate to severe pain. J Pain Res 2012;5:327-46.
  • Wilder-Smith CH, Hill L, Dyer RA, Torr G, Coetzee E. Postoperative sensitization and pain after cesarean delivery and the effects of single im doses of tramadol and diclofenac alone and in combination. Anesth Analg 2003;97:526-33.
  • American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anest 2012;116:248-73.
  • Moizo E, Berti M, Marchetti C, Deni F, Albertin A, Muzzolon F, Antonino A. Acute Pain Service and multimodal therapy for postsurgical pain control: evaluation of protocol efficacy. Minerva Anestesiol 2004;70:779-87.
There are 40 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Kadriye Acar

Hüseyin Acar

Figen Demir

Fatma Eti Aslan

Publication Date June 1, 2016
Published in Issue Year 2016Issue: 2

Cite

EndNote Acar K, Acar H, Demir F, Aslan FE (June 1, 2016) Cerrahi Sonrası Ağrı Insidansı ve Analjezik Kullanım Miktarının Belirlenmesi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2 89–95.