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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
131

Anestesisjuksköterskors erfarenheter av postoperativ smärtlindring av barn : En kvalitativ intervjustudie / Anesthesia nurses experiences of giving postoperative pain relief to children : A qualitative interview study

Dobrin, Leif, Wall, Niklas January 2009 (has links)
<p><strong>Bakgrund:</strong> Att förebygga, bedöma och behandla smärta är centralt i anestesisjuksköterskans arbete. Barns upplevelser och uttryckssätt vid smärta skiljer sig mycket från vuxnas. Det är därför en stor utmaning för anestesisjuksköterskor att tolka barns uttryck och känslor för att förstå barnet och kunna erbjuda trygghet och smärtlindring. Forskning har visat att barns postoperativa smärta underbehandlas, trots att kunskaperna om barns smärta ökat. Genom att belysa anestesisjuksköterskans upplevelser kan förståelsen för vad som bidrar till en god respektive mindre god postoperativ smärtlindring av barn öka.</p><p><strong>Syfte:</strong> Syftet med denna studie var att beskriva anestesisjuksköterskors erfarenheter i samband med postoperativ smärtlindring av barn.</p><p><strong>Metod:</strong> Semistrukturerade intervjuer genomfördes med åtta anestesisjuksköterskor från ett svenskt länssjukhus i mellersta Norrland.  Insamlad data analyserades med manifest innehållsanalys.</p><p><strong>Resultat:</strong> Utifrån analysen framkom tre kategorier och sju subkategorier. De tre kategorierna var: Att skapa kontakt är en utmaning, Helhetstänkande och Rutiner.  Det var en utmaning för anestesisjuksköterskan att skapa kontakt med ett barn som varit sövd. Det var viktigt att alla personalgrupper samt föräldrar samarbetade, och den egna erfarenheten var den viktigaste källan till kunskap samt att det fanns brister gällande skriftliga rutinbeskrivningar.Diskussion: Det är viktigt att det finns tydliga rutiner som underlättar smärtlindringen av barn postoperativt och barn bör bedöma den egna smärtan i så stor utsträckning som möjligt. Det var viktigt att ha en god planering t.ex. att påbörja smärtlindringen tidigt. Stress och oro innan operation kunde ge effekter långt tid efter. Föräldrarna var viktiga och skall involveras i vården för att vara ett stöd för sitt barn. Barn kan reagera kraftigt på anestesiläkemedel och därför bör de väckas långsamt och under lugna förhållanden.</p> / <p><strong>Background:</strong> To prevent, assess and treat pain is central to anesthesia nurses work. Children's experiences and expression of pain are very different from adults. It is therefore a major challenge for anesthesia nurses to interpret children's expressions and emotions in order to understand the child, and to offer security and pain relief. Research has shown that children's postoperative pain is undertreated, despite that the knowledge of children's pain has increased. By highlighting anesthesia nurses’ experiences the understanding may increase concerning factors that contributes to a good or not so good postoperative pain relief in children.</p><p><strong>Objective:</strong> The purpose of this study was to describe anesthesia nurses' experiences when caring for children with a need of postoperative pain relief.</p><p><strong>Method:</strong> Semi-structured interviews were carried out with eight anesthesia nurses at a county hospital in the north central part of Sweden. Collected data was analyzed with a manifest content analysis.</p><p><strong>Results:</strong> From the analysis three categories and seven sub-categories emerged. The three categories were: To create communication is a challenge, Holistic thinking and Routines.  It was a challenge for the anesthesia nurses to communicate with a child that has been put to sleep. It was also of importance that all healthcare staff and parents cooperated. The anesthesia nurses own experiences was the main source of knowledge and there was a shortage of written routine descriptions.Discussion: It is of importance to have clear procedures to facilitate pain relief of children postoperatively and children should assess their own pain as much as possible. To have a good planning e.g. to initiate pain relief before the operation was also of importance. Stress and anxiety before surgery may have an impact long time after the treatment was over. Parents are important and should be involved in the care so they can support their child. Children may react strongly to the anesthesia drugs and therefore they should be brought back slowly postoperatively and in calm conditions.</p>
132

Förebyggande av postoperativ myalgi / Prevention of postoperative myalgia

Pettersson, Maria January 2010 (has links)
<p>Succinylcolin är ett icke-depolariserande muskelrelaxantia som används inom anestesisjukvård. En vanlig biverkning är postoperativ myalgi. Varför smärtan uppstår är inte helt klarlagd. Under många år har forskare runt om i världen försökt komma till rätta med problemet utan att helt lyckas.Olika läkemedel och strategier har prövats. En av de viktigaste uppgifter en sjuksköterska har är att förebygga och lindra lidande. Som anestesisjuksköterska finns det möjlighet att påverka den vård som ordineras. Syftet med studien var att undersöka vilka metoder som kan förebygga postoperativ myalgi orsakad av succinylcolin. En litteraturstudie baserad på tio vetenskapliga artiklar genomfördes. Resultatet visade att parecoxib preoperativt samt premedicinering med diklofenakplåster gav det bästa resultatet när det gäller reducerande av myalgi. Med hjälp av dessa så vanliga läkemedel kan onödigt lidande förebyggas och samhällsekonomiska resurser sparas.</p><p> </p>
133

"LIA eller morfin spinalt vid primär total höftplastik". : en långtidsuppföljning av effekter för postoperativ smärta och mobilisering.

Lassas, Anna January 2009 (has links)
<p>Vid operation av primär total höftplastik finns det olika metoder för postoperativ smärtlindring. En tidigare genomförd studie på ett mellansvenskt sjukhus (nedan kallad ”höftprojektet”) visade att ”Local infiltration analgesia” (LIA) initialt minskade postoperativ smärta, underlättade mobilisering samt förkortade vårdtiden, jämfört med spinalt morfin. I denna studie genomfördes en långtidsuppföljning av höftprojektet med mätningar efter 6 respektive 12 veckor. Studiegruppen hade fått LIA vid operationsslutet och kontrollgruppen spinalt morfin. Båda grupperna hade en spinal bedövning under operationen. Denna långtidsuppföljning genomfördes med hjälp av journalgranskning och hade en deskriptiv och jämförande design med en kvantitativ ansats. Studiegruppen bestod av 40 patienter och kontrollgruppen 11 patienter. Studerade variabler var smärta mätt genom Visuell Analog Skala (VAS), behov av analgetika och mobilisering. Resultatet visade att det inte fanns någon signifikant skillnad mellan de båda grupperna när det gäller mobilisering under ett längre perspektiv. Det fanns dock en signifikant skillnad när det gäller smärta efter 3 månader, då studiegruppen uppgav en lägre grad av smärta än kontrollgruppen.</p> / <p>There are several methods for postoperative pain treatment after primary total hip replacement. It was shown in a earlier study at a Swedish hospital (below named as "the hip project") that "Local infiltration analgesia" (LIA) decreased pain, facilitated early postoperative mobility and earlier discharge from the hospital, compared with spinally administered morphine. Present study is a long term follow up of the hip project with two measures at 6 and 12 weeks. The study group was given LIA towards the end of the operation while the control group were given spinal morphine at the induction. Both groups had spinal analgesia during the surgery. The long term follow up was conducted by a comparative design and the data was collected from the patient’s charts and files. The variables were pain measured by Visual Analogous Scale (VAS), need of pain relieves and general mobility. The study group contained of 40 patients and the control group of 11. The result relived no significant differences between the two groups regarding long term mobility. There was, however, a significant difference in pain after 12 weeks; the study group had less pain that the control group.</p><p> </p><p> </p>
134

Förebyggande av postoperativ myalgi / Prevention of postoperative myalgia

Pettersson, Maria January 2010 (has links)
Succinylcolin är ett icke-depolariserande muskelrelaxantia som används inom anestesisjukvård. En vanlig biverkning är postoperativ myalgi. Varför smärtan uppstår är inte helt klarlagd. Under många år har forskare runt om i världen försökt komma till rätta med problemet utan att helt lyckas.Olika läkemedel och strategier har prövats. En av de viktigaste uppgifter en sjuksköterska har är att förebygga och lindra lidande. Som anestesisjuksköterska finns det möjlighet att påverka den vård som ordineras. Syftet med studien var att undersöka vilka metoder som kan förebygga postoperativ myalgi orsakad av succinylcolin. En litteraturstudie baserad på tio vetenskapliga artiklar genomfördes. Resultatet visade att parecoxib preoperativt samt premedicinering med diklofenakplåster gav det bästa resultatet när det gäller reducerande av myalgi. Med hjälp av dessa så vanliga läkemedel kan onödigt lidande förebyggas och samhällsekonomiska resurser sparas.
135

"LIA eller morfin spinalt vid primär total höftplastik". : en långtidsuppföljning av effekter för postoperativ smärta och mobilisering.

Lassas, Anna January 2009 (has links)
Vid operation av primär total höftplastik finns det olika metoder för postoperativ smärtlindring. En tidigare genomförd studie på ett mellansvenskt sjukhus (nedan kallad ”höftprojektet”) visade att ”Local infiltration analgesia” (LIA) initialt minskade postoperativ smärta, underlättade mobilisering samt förkortade vårdtiden, jämfört med spinalt morfin. I denna studie genomfördes en långtidsuppföljning av höftprojektet med mätningar efter 6 respektive 12 veckor. Studiegruppen hade fått LIA vid operationsslutet och kontrollgruppen spinalt morfin. Båda grupperna hade en spinal bedövning under operationen. Denna långtidsuppföljning genomfördes med hjälp av journalgranskning och hade en deskriptiv och jämförande design med en kvantitativ ansats. Studiegruppen bestod av 40 patienter och kontrollgruppen 11 patienter. Studerade variabler var smärta mätt genom Visuell Analog Skala (VAS), behov av analgetika och mobilisering. Resultatet visade att det inte fanns någon signifikant skillnad mellan de båda grupperna när det gäller mobilisering under ett längre perspektiv. Det fanns dock en signifikant skillnad när det gäller smärta efter 3 månader, då studiegruppen uppgav en lägre grad av smärta än kontrollgruppen. / There are several methods for postoperative pain treatment after primary total hip replacement. It was shown in a earlier study at a Swedish hospital (below named as "the hip project") that "Local infiltration analgesia" (LIA) decreased pain, facilitated early postoperative mobility and earlier discharge from the hospital, compared with spinally administered morphine. Present study is a long term follow up of the hip project with two measures at 6 and 12 weeks. The study group was given LIA towards the end of the operation while the control group were given spinal morphine at the induction. Both groups had spinal analgesia during the surgery. The long term follow up was conducted by a comparative design and the data was collected from the patient’s charts and files. The variables were pain measured by Visual Analogous Scale (VAS), need of pain relieves and general mobility. The study group contained of 40 patients and the control group of 11. The result relived no significant differences between the two groups regarding long term mobility. There was, however, a significant difference in pain after 12 weeks; the study group had less pain that the control group.
136

Anestesisjuksköterskors erfarenheter av postoperativ smärtlindring av barn : En kvalitativ intervjustudie / Anesthesia nurses experiences of giving postoperative pain relief to children : A qualitative interview study

Dobrin, Leif, Wall, Niklas January 2009 (has links)
Bakgrund: Att förebygga, bedöma och behandla smärta är centralt i anestesisjuksköterskans arbete. Barns upplevelser och uttryckssätt vid smärta skiljer sig mycket från vuxnas. Det är därför en stor utmaning för anestesisjuksköterskor att tolka barns uttryck och känslor för att förstå barnet och kunna erbjuda trygghet och smärtlindring. Forskning har visat att barns postoperativa smärta underbehandlas, trots att kunskaperna om barns smärta ökat. Genom att belysa anestesisjuksköterskans upplevelser kan förståelsen för vad som bidrar till en god respektive mindre god postoperativ smärtlindring av barn öka. Syfte: Syftet med denna studie var att beskriva anestesisjuksköterskors erfarenheter i samband med postoperativ smärtlindring av barn. Metod: Semistrukturerade intervjuer genomfördes med åtta anestesisjuksköterskor från ett svenskt länssjukhus i mellersta Norrland.  Insamlad data analyserades med manifest innehållsanalys. Resultat: Utifrån analysen framkom tre kategorier och sju subkategorier. De tre kategorierna var: Att skapa kontakt är en utmaning, Helhetstänkande och Rutiner.  Det var en utmaning för anestesisjuksköterskan att skapa kontakt med ett barn som varit sövd. Det var viktigt att alla personalgrupper samt föräldrar samarbetade, och den egna erfarenheten var den viktigaste källan till kunskap samt att det fanns brister gällande skriftliga rutinbeskrivningar.Diskussion: Det är viktigt att det finns tydliga rutiner som underlättar smärtlindringen av barn postoperativt och barn bör bedöma den egna smärtan i så stor utsträckning som möjligt. Det var viktigt att ha en god planering t.ex. att påbörja smärtlindringen tidigt. Stress och oro innan operation kunde ge effekter långt tid efter. Föräldrarna var viktiga och skall involveras i vården för att vara ett stöd för sitt barn. Barn kan reagera kraftigt på anestesiläkemedel och därför bör de väckas långsamt och under lugna förhållanden. / Background: To prevent, assess and treat pain is central to anesthesia nurses work. Children's experiences and expression of pain are very different from adults. It is therefore a major challenge for anesthesia nurses to interpret children's expressions and emotions in order to understand the child, and to offer security and pain relief. Research has shown that children's postoperative pain is undertreated, despite that the knowledge of children's pain has increased. By highlighting anesthesia nurses’ experiences the understanding may increase concerning factors that contributes to a good or not so good postoperative pain relief in children. Objective: The purpose of this study was to describe anesthesia nurses' experiences when caring for children with a need of postoperative pain relief. Method: Semi-structured interviews were carried out with eight anesthesia nurses at a county hospital in the north central part of Sweden. Collected data was analyzed with a manifest content analysis. Results: From the analysis three categories and seven sub-categories emerged. The three categories were: To create communication is a challenge, Holistic thinking and Routines.  It was a challenge for the anesthesia nurses to communicate with a child that has been put to sleep. It was also of importance that all healthcare staff and parents cooperated. The anesthesia nurses own experiences was the main source of knowledge and there was a shortage of written routine descriptions.Discussion: It is of importance to have clear procedures to facilitate pain relief of children postoperatively and children should assess their own pain as much as possible. To have a good planning e.g. to initiate pain relief before the operation was also of importance. Stress and anxiety before surgery may have an impact long time after the treatment was over. Parents are important and should be involved in the care so they can support their child. Children may react strongly to the anesthesia drugs and therefore they should be brought back slowly postoperatively and in calm conditions.
137

Perioperative effects of systemic or spinal clonidine as adjuvant during spinal anaesthesia /

Dobrydnjov, Igor, January 2004 (has links) (PDF)
Diss. Linköping : Univ., 2004.
138

Pregabalina para melhoria na qualidade de recuperação anestésica em cirurgia bariátrica: ensaio clínico randomizado, duplo cego, placebo controlado / Pregabalin to improve postoperative recovery after bariatric surgery: a prospective, randomized, double-blinded, placebo-controlled study

Martins, Marcelo de Jesus 11 December 2017 (has links)
Submitted by MARCELO DE JESUS MARTINS null (celoufba@yahoo.com.br) on 2018-01-05T11:45:24Z No. of bitstreams: 1 Marcelo Martins (Tese de Doutorado).pdf: 3508982 bytes, checksum: ff73bd80060bf710ecc113d389df649e (MD5) / Approved for entry into archive by ROSANGELA APARECIDA LOBO null (rosangelalobo@btu.unesp.br) on 2018-01-05T17:19:45Z (GMT) No. of bitstreams: 1 martins_mj_dr_bot.pdf: 3508982 bytes, checksum: ff73bd80060bf710ecc113d389df649e (MD5) / Made available in DSpace on 2018-01-05T17:19:45Z (GMT). No. of bitstreams: 1 martins_mj_dr_bot.pdf: 3508982 bytes, checksum: ff73bd80060bf710ecc113d389df649e (MD5) Previous issue date: 2017-12-11 / Justificativa: a obesidade é uma doença crônica caracterizada por acúmulo excessivo de gordura corporal. Devido aos riscos associados, é considerada um grande problema de saúde pública nos países desenvolvidos. A cirurgia bariátrica (gastroplastia aberta) tem sido usada como uma estratégia importante para tratar esta condição nos países em desenvolvimento, especialmente quando associada a outras comorbidades. A qualidade de recuperação, no entanto, tem sido uma preocupação frequente no manejo pós-operatório desses pacientes. A pregabalina é um análogo estrutural do neurotransmissor ácido gama-aminobutírico (GABA) que se liga à subunidade alfa-2 do canal de cálcio voltagem dependente, bloqueando o desenvolvimento da hiperalgesia e a sensibilização central à dor. Objetivo: o objetivo principal da pesquisa foi avaliar o efeito da pregabalina perioperatória versus placebo na qualidade de recuperação pós-operatória em pacientes submetidos à cirurgia bariátrica. Métodos: trata-se de estudo prospectivo, randomizado, controlado com placebo, duplo cego. Após a aprovação do Comitê de Ética, setenta pacientes submetidos à gastroplastia abdominal foram randomizados para receber pregabalina, grupo 1 (75 mg por via oral 1 hora antes da cirurgia) ou uma pílula de placebo idêntica, grupo 2. O desfecho primário foi a avaliação da qualidade da recuperação (questionário QoR-40) em 24 horas. Os resultados secundários incluíram o consumo de opioides e os escores de dor pós-operatória. Um valor de P <0,05 foi usado para rejeitar erro de tipo I. Resultados: foram randomizados setenta pacientes e 60 indivíduos completaram o estudo. A mediana dos escores globais de recuperação (qualidade de recuperação QoR-40) às 24 horas após a cirurgia no grupo de pregabalina foi de 185 (176-191) x 184 (174-192) no grupo placebo (P = 0,95). O consumo total de opioides nas 24 horas não apresentou diferença estatisticamente significativa entre os grupos. Além disso, a incidência de náusea, o vômitos e o tempo de alta da unidade de cuidados pós-anestésicos não foram significativamente reduzidos no grupo pregabalina em comparação com o placebo. Conclusões: o uso pré-operatório de pregabalina não resulta em melhora na qualidade da recuperação pós-operatória, redução dos escores de dor, bem como redução do consumo de opioides em pacientes submetidos à cirurgia bariátrica. / Background: obesity is a chronic disease characterized by excessive accumulation of body fat. Due to the associated risks, it has been considered a major public health problem in developed countries. Bariatric surgery (open gastroplasty) has been used as an important strategy to treat this condition in developing countries, especially when associated with other comorbidities. The quality of recovery, however, has been a frequent concern in the postoperative management of these patients. Pregabalin is a structural analogue of the gamma-aminobutyric acid neurotransmitter (GABA) that binds to the alpha-2-subunit of the voltage-dependent calcium channel, blocking the development of hyperalgesia and central pain sensitization. Objective: the main objective of the current investigation was to evaluate the effect of perioperative pregabalin versus placebo on postoperative quality of recovery in patients undergoing bariatric surgery. Methods: the study was a prospective, randomized, placebo-controlled, double-blinded trial. After ethics committee approval, seventy patients undergoing abdominal gastroplasty were randomized to receive pregabalin, group 1 (75 mg orally 1 hour before surgery) or an identical placebo pill, group 2. The primary outcome was the quality of recovery-40 score at 24 hours. Secondary outcomes included opioid consumption and postoperative pain scores. A P value <0.05 was used to reject type I error. Results: seventy patients were randomized and 60 subjects completed the study. The median in global recovery scores (quality of recovery-40) at 24 hours after surgery in pregabalin group was 185 (176-191) x 184 (174-192) in placebo group (P = 0.95). Total opioid consumption in the 24 hours did not present a statistically significant difference between the groups. In addition, nausea, vomiting, and time to post-anesthesia care unit discharge were not significantly reduced in the pregabalin group compared with placebo. Conclusions: preoperative use of pregabalin showed no improve in quality of postoperative recovery, no better pain relief as well as reduction of opioid consumption in patients submitted to bariatric surgery.
139

Avalia??o da dor p?s-operat?ria: an?lise em pacientes submetidos a cirurgias abdominais em um hospital universit?rio de Natal/RN

Rufino, Fatima Haryanny Gomes 05 November 2010 (has links)
Made available in DSpace on 2014-12-17T14:46:44Z (GMT). No. of bitstreams: 1 FatimaHGRM_DISSERT.pdf: 2336964 bytes, checksum: 9165fe3152c282073444e29ba58e9306 (MD5) Previous issue date: 2010-11-05 / It is an exploratory and descriptive study made by a quantitative approach, developed among February and May 2010, aiming to assess the pain of patients underwent abdominal surgeries in a University Hospital, in Natal/RN; to identify the local and intensity of the pain based on Numerical Estimative Scale; to analyze the pain related to the sensorial-discriminative, motivational-affective and cognitive-assessment dimensions, using the McGill Questionnaire pain; to establish a relation between the pain process and age, gender, religion, and king of surgery; to identify the medicines efficiency used to control postoperative pain. The sample was composed by 253 patients underwent abdominal surgeries. The results showed a total of 63.63% females between 38 and 47 years of age (21.34%); illiterates (21.73%); married (64.03%), living in Natal and surroundings (67.97%) and Catholics (74.30%). In their first assessment, 84.19% showed postoperative pain; the pain was considered light in 18.97% of them, moderate in 21.74% and severe in 43.48%. The mean number of descriptors chosen through the McGill Questionnaire Pain was 10.78 (DP= 6.09) and pain rating 23.65 (DP= 15.93). The descriptors selected with higher frequency were: sickening pain (69.01%), tired (65.25%), thin (62.44%), bored (58.69%), ardor (46.48%), pointed (38.50%) and colic (35.21%). In their second assessment, 57.71% of patients didn t relate any postoperative pain and 42.29% were still complaining about the pain. After taking analgesic medication, just 41.90% of patients who had complete pain relief. The Pharmacological groups most used were: simple analgesic (37.86%), weak opioids (32.98%), AINES (19.85%) and strong opioid (9.31%). It was not found a significant postoperative pain variation related to the sexes, religion and kind of surgery. It was concluded there were a high level in the number of patients with postoperative pain, mainly in a severe scale. Less than half of patients had the pain relief. Then, it was observed there was not coherence between the pain intensity and the analgesic it was used. To solve or relieve this kind of problems is necessary a permanent education to the health professionals who works in this area / Estudo explorat?rio descritivo, com abordagem quantitativa, desenvolvido entre fevereiro e maio de 2010, com o objetivo de avaliar a dor dos pacientes submetidos a cirurgias abdominais em um Hospital Universit?rio, em Natal/RN; identificar a localiza??o e a intensidade dolorosa mensurada pela Escala de Estimativa Num?rica; analisar a dor nas dimens?es sensorial-discriminativa, motivacional-afetiva e a cognitivo-avaliativa, utilizando o Question?rio para dor McGill; relacionar o processo ?lgico com a idade, sexo, religi?o e tipo de abordagem cir?rgica; identificar a efetividade da medica??o utilizada no al?vio da dor p?s-operat?ria. A amostra constou de 253 pacientes submetidos a cirurgias abdominais. Os resultados mostraram que 63,63% eram mulheres, entre 38 e 47 anos (21,34%); n?o alfabetizados (21,73%), casadas (64,03%), procedentes da grande Natal (67,97%) e cat?licas (74,30%). Na primeira avalia??o, 84,19% apresentaram dor p?s-operat?ria; 18,97% apresentaram dor leve; 21,74% moderada e 43,48% severa. A m?dia do n?mero de descritores escolhidos atrav?s do Question?rio de Dor McGill foi 10,78 (DP= 6,09) e o ?ndice de dor 23,65 (DP= 15,93). Os descritores escolhidos com maior frequ?ncia foram: dor enjoada (69,01%), cansativa (65,25%), fina (62,44%), aborrecida (58,69%), ardor (46,48%), pontada (38,50%) e c?lica (35,21%). Na segunda avalia??o, 57,71% pacientes n?o referiram dor p?s-operat?ria e 42,29% continuaram com queixas de dor. Apenas 41,90% dos pacientes tiveram sua dor totalmente aliviada ap?s administra??o do analg?sico. Os grupos farmacol?gicos mais utilizados foram os analg?sicos simples 37,86%, opi?ides fracos 32,98%, AINES 19,85% e opi?ides fortes 9,31%. N?o encontramos rela??o significativa entre a vari?vel dor p?s-operat?ria com o sexo, religi?o e tipo de abordagem cir?rgica. Conclu?mos que houve uma alta preval?ncia de dor p?s-operat?ria, principalmente a de intensidade severa. A dor foi efetivamente aliviada em menos da metade dos pacientes. Dessa forma, percebemos que n?o existia coer?ncia entre a intensidade da dor do paciente e o analg?sico administrado para o seu al?vio. A educa??o permanente dos profissionais de sa?de dever? ser uma das a??es mais eficazes para evitar ou minimizar a ocorr?ncia desse evento
140

Pregabalina para melhoria na qualidade de recuperação anestésica em cirurgia bariátrica ensaio clínico randomizado, duplo cego, placebo controlado /

Martins, Marcelo de Jesus January 2017 (has links)
Orientador: Norma Sueli Pinheiro Módolo / Resumo: Justificativa: a obesidade é uma doença crônica caracterizada por acúmulo excessivo de gordura corporal. Devido aos riscos associados, é considerada um grande problema de saúde pública nos países desenvolvidos. A cirurgia bariátrica (gastroplastia aberta) tem sido usada como uma estratégia importante para tratar esta condição nos países em desenvolvimento, especialmente quando associada a outras comorbidades. A qualidade de recuperação, no entanto, tem sido uma preocupação frequente no manejo pós-operatório desses pacientes. A pregabalina é um análogo estrutural do neurotransmissor ácido gama-aminobutírico (GABA) que se liga à subunidade alfa-2 do canal de cálcio voltagem dependente, bloqueando o desenvolvimento da hiperalgesia e a sensibilização central à dor. Objetivo: o objetivo principal da pesquisa foi avaliar o efeito da pregabalina perioperatória versus placebo na qualidade de recuperação pós-operatória em pacientes submetidos à cirurgia bariátrica. Métodos: trata-se de estudo prospectivo, randomizado, controlado com placebo, duplo cego. Após a aprovação do Comitê de Ética, setenta pacientes submetidos à gastroplastia abdominal foram randomizados para receber pregabalina, grupo 1 (75 mg por via oral 1 hora antes da cirurgia) ou uma pílula de placebo idêntica, grupo 2. O desfecho primário foi a avaliação da qualidade da recuperação (questionário QoR-40) em 24 horas. Os resultados secundários incluíram o consumo de opioides e os escores de dor pós-operatória. Um valor de... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Background: obesity is a chronic disease characterized by excessive accumulation of body fat. Due to the associated risks, it has been considered a major public health problem in developed countries. Bariatric surgery (open gastroplasty) has been used as an important strategy to treat this condition in developing countries, especially when associated with other comorbidities. The quality of recovery, however, has been a frequent concern in the postoperative management of these patients. Pregabalin is a structural analogue of the gamma-aminobutyric acid neurotransmitter (GABA) that binds to the alpha-2-subunit of the voltage-dependent calcium channel, blocking the development of hyperalgesia and central pain sensitization. Objective: the main objective of the current investigation was to evaluate the effect of perioperative pregabalin versus placebo on postoperative quality of recovery in patients undergoing bariatric surgery. Methods: the study was a prospective, randomized, placebo-controlled, double-blinded trial. After ethics committee approval, seventy patients undergoing abdominal gastroplasty were randomized to receive pregabalin, group 1 (75 mg orally 1 hour before surgery) or an identical placebo pill, group 2. The primary outcome was the quality of recovery-40 score at 24 hours. Secondary outcomes included opioid consumption and postoperative pain scores. A P value <0.05 was used to reject type I error. Results: seventy patients were randomized and 60 subjects comple... (Complete abstract click electronic access below) / Doutor

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