Analysis of the concordance prescription-administration of analgesics during the immediate postoperative period
DOI:
https://doi.org/10.51481/amc.v47i4.205Keywords:
acute pain, postoperative pain, diclofenac, tramadol, prescription, complianceAbstract
Objective:To compare the prescription and administration of postopertaive analgesics (first 24 hours) in patientswho underwent orthopedic surgery.
Methods:Observational study. Information was obtainedfrom the medical charts of 60 patients (30 female and 30male), who underwent elective orthopedic surgery of theextremities at a general hospital; ASA I (80%) and ASA II(20%), none with documented allergy to analgesics or anti-inflammatory agents. We performed crossed confirmationwith the nurse s chartboard and patients interviews.Variables: fulfillment of the prescription (total administerddoses: 120 doses of diclofenac or 180 doses of tramadol),fulfillment of the dose (real application of prescribed dose:diclofenac 75 mg and tramadol 50 mg), fulfillment of inter-vals (temporary deflection of 12 hours for diclofenac and of8 hours for trramadol), and prescription-administrationvariations (additional applications or omissions).Descriptive analisis.
Results:All patients were prescribed with diclofenac;63.3% with 75 mg (1 vial) every 12 hours I.M., and tra-madol 50 mg (1/2 vial) every 6 hours S.C. Diclofenac: 50%received only one dose, 33.4% two doses, and one patientreceived tree doses; prescription s fulfillment= 59.2%.Second dose 14.86 ± 4.33 hours after the first dose, inter-val s fulfillment= 18.3% (+3 hours delay). Tramadol:68.0% received one dose and 20% received two doses; pre-scription s fulfillment= 32.8%. Second dose 12.81 ± 6.07hours after the dirst dose; interval s fulfillment= 37.5% (+5hours delay). For both drugs: dose s fulfillment= 100%.Variations 21.7%: 2 patients received tramadol without pre-scription, the administration of the drug was omitted in 11patients.
Conclusions:The observed drug administration does notadjust to the prescribing profile, at least for the first 24hours after surgery as inpatient care. The drug administra-tion must improve towards the patients benefit
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