Pain consequences in patients undergoing elective craniotomy / Las consecuencias del dolor en pacientes sometidos a craneotomía electiva

El dolor en la craneotomía postoperatoria compromete el cuadro clínico-quirúrgico de los pacientes. El estudio tuvo como objetivo identificar las consecuencias del dolor en pacientes sometidos a craneotomía electiva. Ésta es una visión de un estudio descriptivo, longitudinal. La muestra estuvo constituida de 100 pacientes sometidos a craneotomía electiva. Los datos fueron recolectados entre septiembre de 2010 y octubre de 2011. Las variables estudiadas fueron el insomnio, tos, apetito y la deambulación. Se realizó un análisis descriptivo de las variables, se utilizaron medidas de tendencia central, dispersión y el análisis de las proporciones. Los datos muestran que del 1º al 8º día postoperatorio, el insomnio estuvo presente en 19 por ciento y 6,4 por ciento de los casos, respectivamente, el 19 por ciento de los pacientes reportaron que el dolor le impedía la tos en los primeros días después de la cirugía. Disminución del apetito en el 11 por ciento de los pacientes en la evaluación del primer día y en el octavo día después de la cirugía en el 4,3 por ciento de los casos este síntoma persistía. En el tercer día después de la cirugía 8,24 por ciento de los encuestados informaron que el dolor impidió la deambulación, este síntoma es menos común durante el seguimiento. Se concluye que la evaluación y el tratamiento del dolor postoperatorio adecuado es fundamental para evitar las complicaciones quirúrgicas y el sufrimiento de los pacientes.

The pain in postoperative craniotomy compromises the charts of surgical patients. This study aimed to identify the consequences of pain in patients undergoing elective craniotomy. This is a descriptive study, longitudinal. The sample was comprised of 100 patients undergoing elective craniotomy. Data collection occurred in September 2010 to October 2011. The variables studied were insomnia, coughing, appetite and ambulation. A descriptive analysis of the variables was conducted; measures of central tendency, dispersion and analysis of proportions were used. The data show that from the 1st to the 8th postoperative day the insomnia was present in 19 percent and 6.4 percent of the cases, respectively, 19 percent of patients reported that the pain prevented coughing on the first postoperative day. Appetite decrease in 11 percent of patients on the first evaluation day and on the eighth day post-operative in 4.3 percent of the cases this symptom persisted. On the third post-operative day 8.24 percent of those interviewed reported that the pain prevented ambulation, being that this symptom was less frequent during the follow-up. It is concluded that the adequate assessment and postoperative pain treatment are fundamental in avoiding surgical complications, and patients’ suffering.

Dor pós-operatória em pacientes submetidos à craniotomia eletiva / Postoperative pain in patients submitted to elective craniotomy

JUSTIFICATIVA E OBJETIVOS: A dor é uma experiência subjetiva e multidimensional, comum em pacientes submetidos a operações. Os objetivos do estudo foram identificar a intensidade e verificar o registro da dor em prontuário, de pacientes submetidos à craniotomia eletiva. MÉTODO: Estudo descritivo, quantitativo. Foram estudados 100 pacientes submetidos à craniotomia. As variáveis pesquisadas foram idade, sexo, tipo de operação, presença e intensidade da dor, registro da dor e uso de analgésicos no pós-operatório. Realizou-se a análise descritiva das variáveis estudadas, utilizando-se medidas de tendência central, dispersão e análise de proporções. RESULTADOS: Os dados deste estudo demonstram que 59% dos pacientes submetidos à craniotomia eram do sexo feminino, com média de idade 44,6 ± 14,5 anos, 57% eram solteiros, e tiveram uma média de internação na unidade de terapia intensiva (UTI) e no hospital de 2,8 ± 2,4 e 21,8 ± 16,9 dias, respectivamente. Em 55% dos casos o diagnóstico médico foi de tumor cerebral, e o tipo de operação foi supratentorial em 90% dos pacientes. A cefaleia foi a principal queixa no pós-operatório, classificada na maioria das vezes como moderada, do tipo contínua. A maioria dos pacientes não recebeu qualquer tipo de medicação analgésica. Na maior parte dos prontuários não havia registro da dor pela equipe de saúde. CONCLUSÃO: Os dados demonstram a necessidade de aperfeiçoamento dos profissionais da saúde para o tratamento e a avaliação da dor de maneira sistemática.

BACKGROUND AND OBJECTIVES: Pain is subjective and multidimensional and is common in the postoperative period. This study aimed at identifying intensity and at checking pain records of patients submitted to elective craniotomy. METHOD: This is a descriptive and quantitative study involving 100 patients submitted to craniotomy. Studied variables were age, gender, type of surgery, pain and pain intensity, pain records and the use of analgesics in the postoperative period. Studied variables were submitted to descriptive analysis using central trend measurements, dispersion and ratio analysis. RESULTS: Our study has shown that 59% of patients submitted to craniotomy were females, with mean age of 44.6 ± 14.5 years, 57% were single and had mean ICU and hospital stay of 2.8 ± 2.4 e 21.8 ± 16.9 days, respectively. Brain tumor was diagnosed in 55% of cases and surgery was supratentorial in 90% of patients. Headache was the major postoperative complaint, classified as moderate and continuous by most patients. Most patients had no analgesic medication. Most medical records had no pain recorded by the health team. CONCLUSION: Data show the need for health professionals' improvement to systematically treat and evaluate pain.