Control of immediate postoperative acute pain and analysis of the prescription of analgesics in the Hospital San Juan de Dios
DOI:
https://doi.org/10.51481/amc.v41i4.527Keywords:
acute pain, postsurgical pain, pain relief, analgesic drugs, morphineAbstract
Aim: Postsurgical pain is frequent, acute and very intense; potent analgesics are necessary to relieve it. In our country, a previous study showed a high prevalence of this symptom and a suboptimal use of analgesic drugs. The aim of the present study was to evaluate the pharmacological control of acute pain after open abdominal surgery in the immediate postsurgical period, and the use of the profile of parenteral analgesics drugs in a class A hospital, Hospital San Juan de Dios.
Methods: An observational, descriptive and transversal study during the first 24 hours of postsurgical time; a n= 76 adult patients (26 men and 51 women, 13-88 years) were included. An indication-prescription analysis was performed and the patients were interviewed in the post-surgical room to qualify their pain using a rating scale of pain, from September to November 1999, at the Departament of General Surgery, Hospital San Juan de Dios.
Results: The results of the interview showed that only 82% of patients referred pain at that moment (20% moderate pain and 25% intense or unbearable pain), although 47% of all patients had received one analgesic dose during the past 3 hours. In total, 82% related pain during the previous hours (51 % moderate or most severe pain), although some of them received parenteral analgesics. Morphine was prescribed to 58% of patients (30% as a single analgesic and 30% with tramadol); this drug was prescribed with dosification interval greater to 6 hours in 38% of cases and in 62% cases doses of 7.5 mg were used; one single dose was administred to 49% of patients. Tramadol was prescribed in 9% (65% in dose of 50 mg) and diclofenac for 14% of the cases as a single drug; there drugs were prescribed in combination in 18% of cases.
Conclusions: Post-surgical acute pain was undesirably frequent and intense. Partial and insufficient relief of acute pain was achieved, even though potent analgesics are available. Analgesics drugs were poorly employed and posology profiles did not show a rational prescription (specially morphine). The higher prevalence ofpostsurgical pain and the lower impact of analgesics drugs in acute pain relief was due to a poor rationale drug use.
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