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Abstract(s)
Introdução: A dor aguda é um fenómeno fisiológico limitado no tempo e que permite a sinalização de uma lesão ou disfunção orgânica. A dor no doente crítico, seja por causas médicas, cirúrgicas ou resultante de procedimentos diagnósticos e/ou terapêuticos, é muito frequente. A sua prevenção e tratamento adequados dependem de uma avaliação sistemática deste sinal vital. A falência desta abordagem poderá resultar em fenómenos de cronificação da dor com impacto significativo na qualidade de vida.
Objetivos principais: O presente trabalho tem como objetivos (1) estudar a regularidade da avaliação da dor no doente crítico médico nas primeiras 24 horas de internamento e (2) estudar o tratamento da dor aguda na realização de procedimentos com potencial álgico.
Materiais e métodos: A recolha de dados decorreu durante seis meses, em dois momentos distintos, um momento retrospetivo, entre outubro e dezembro de 2015 e, um momento prospetivo, de fevereiro a abril de 2016. Os dados das amostras foram recolhidos utilizando o processo clínico de cada doente e a folha de registo de abordagem da dor. Excluíram-se doentes com idade inferior a 18 anos e doentes cirúrgicos. O tratamento de dados foi realizado através do IBM SPSS Statistics versão 23.0.
Resultados: Verificou-se que em 89,13% dos casos foram realizadas entre três a seis avaliações da dor nas primeiras 24 horas de internamento; 10,87% dos doentes têm menos de três avaliações e nenhum doente teve mais de seis avaliações. Em apenas 28% dos procedimentos com potencial álgico foi administrada terapêutica analgésica.
Discussão: A avaliação da dor foi adequadamente realizada na maioria dos doentes (89,13%). Apesar desta avaliação sistemática, em apenas 28% dos procedimentos foi administrada terapêutica analgésica. A instabilidade clínica característica destes doentes e a inexistência de protocolos de tratamento de dor poderão justificar esta avaliação subótima e a reduzida adesão ao tratamento da mesma, respetivamente.
Conclusão: A dor no doente crítico é comum, independentemente do seu motivo de admissão. Apesar da frequência de avaliação da dor, nesta unidade, estar de acordo com o recomendado pela Direção Geral de Saúde, a administração de terapêutica analgésica nos procedimentos com potencial álgico observou-se numa reduzida percentagem. A criação de protocolos de analgesia assume-se como uma prioridade na tentativa de melhorar a prevenção e o tratamento da mesma.
Introduction: Pain is a time-limited physiological phenomenon that allows signaling an injury or organic dysfunction. Critical patient pain is quite common, whether due to medical or surgical reasons, or as an outcome of diagnostic and/or therapeutic procedures. Their proper prevention and treatment relies upon a systematic evaluation of the vital signal. Failure of this approach may result in pain chronification phenomena with a significant impact on the patient’s quality of life. Main objectives: This study aims to (1) study the regularity of pain assessment in the critical medical patient in the first 24 hours of hospitalization and (2) to study the treatment of acute pain in the performance of procedures with algic potential. Materials and methods: Data collection took place during six months, at two distinct times, a retrospective time between October and December 2015, and a prospective time, from February to April 2016. The data from the samples was collected using each patient’s medical record and the record sheet for approaching pain. Patients younger than 18 years and surgical patients were excluded. Data processing was performed using IBM SPSS Statistics version 23.0. Results: It was verified that in 89,13% of the cases, three to six pain evaluations were performed in the first 24 hours of hospitalization; 10,87% of patients had less than three evaluations and no patient had more than six evaluations. Analgesic therapy was solely supplied to 28% of the procedures with algic potential. Discussion: Pain assessment was adequately performed in most patients (89,13%). Despite this systematic evaluation, analgesic therapy was administered in only 28% of the procedures. The clinical instability characteristic of these patients and the lack of pain treatment protocols may justify this suboptimal evaluation and the reduced adherence to the treatment of the same, respectively. Conclusion: Pain is common for the critically ill patient regardless of his/hers reason for admission. Although the frequency of pain evaluation in this unit is in accordance with that recommended by the General Directorate of Health, the administration of analgesic therapy in procedures with pain potential was observed in a small percentage. The creation of analgesia protocols is a priority in the attempt of improving prevention and treatment of the same.
Introduction: Pain is a time-limited physiological phenomenon that allows signaling an injury or organic dysfunction. Critical patient pain is quite common, whether due to medical or surgical reasons, or as an outcome of diagnostic and/or therapeutic procedures. Their proper prevention and treatment relies upon a systematic evaluation of the vital signal. Failure of this approach may result in pain chronification phenomena with a significant impact on the patient’s quality of life. Main objectives: This study aims to (1) study the regularity of pain assessment in the critical medical patient in the first 24 hours of hospitalization and (2) to study the treatment of acute pain in the performance of procedures with algic potential. Materials and methods: Data collection took place during six months, at two distinct times, a retrospective time between October and December 2015, and a prospective time, from February to April 2016. The data from the samples was collected using each patient’s medical record and the record sheet for approaching pain. Patients younger than 18 years and surgical patients were excluded. Data processing was performed using IBM SPSS Statistics version 23.0. Results: It was verified that in 89,13% of the cases, three to six pain evaluations were performed in the first 24 hours of hospitalization; 10,87% of patients had less than three evaluations and no patient had more than six evaluations. Analgesic therapy was solely supplied to 28% of the procedures with algic potential. Discussion: Pain assessment was adequately performed in most patients (89,13%). Despite this systematic evaluation, analgesic therapy was administered in only 28% of the procedures. The clinical instability characteristic of these patients and the lack of pain treatment protocols may justify this suboptimal evaluation and the reduced adherence to the treatment of the same, respectively. Conclusion: Pain is common for the critically ill patient regardless of his/hers reason for admission. Although the frequency of pain evaluation in this unit is in accordance with that recommended by the General Directorate of Health, the administration of analgesic therapy in procedures with pain potential was observed in a small percentage. The creation of analgesia protocols is a priority in the attempt of improving prevention and treatment of the same.
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Keywords
Analgesia. Dor Aguda Procedimentos Unidade Cuidados Intensivos