Estudio observacional del control del dolor postoperatorio antes y después de la implementación de una guía del manejo del dolor postoperatorio

Ángeles Mesas Idáñez,Cristina Aguilera Martin, Concepción Muñoz Alcaide,Antonio Vallano Ferraz, M. Victoria Ribera Canudas, Gloria Agreda Martínez, Carme Bosch Graupera, Dolors Botella Samaranch,Jesús Caballero López, María Victoria García Aparicio, Jordi García López,Pilar Gil Rubio, Lluís Gros Subias, Esther Les Morell, Maria Oliveras Arena, Dolors Planas Gras, Lucrecia Ramírez Garceran, María Victoria Ribera Canudas,Sabina Salicrú Riera, Ana María Sánchez Reyes, Trinidad Trull Ventura,Antoni Vallano Ferraz

Medicina Clínica(2019)

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摘要
Background and objectives: Postoperative pain is common in hospitals. Clinical practice guidelines for the control of postoperative pain (CPGPP) have been developed to improve its treatment. The objective of this study was to evaluate the prevalence and intensity of postoperative pain and analgesic norms, before and after the implementation of a CPGPP. Material and method: An observational study was carried out that included 2 cross-sectional studies in 2 separate periods, before and after implementation of the CPGPP. Adult patients postoperated on the first day of admission in the surgery plants were included. Demographic, clinical and pharmacological variables were collected from clinical histories. The intensity of the pain was collected through individual interviews with patients. Results: We included 306 patients in the first period and 317 in the second. There were no differences between patients' demographic and clinical variables and the 2 periods. The prevalence of pain was 92% (IC 95%: 87%-95%) in the first period and 77% (IC 95%: 72%-82%) in the second (P<0.05). The most frequent pain in the last 24 hours was moderate or intense in 53% (IC 95%: 48%-59%) of patients in the first period and in 33% (IC 95%: 28%-38%) of the patients in the second (P <0.05). Conclusions: After the implementation of the CPGPP, a decrease in the prevalence and intensity of pain in patients was observed, but without reaching an optimal level. Continued pain training and assessment measures are therefore necessary for proper pain treatment over time. (C) 2019 Elsevier Espana, S.L.U. All rights reserved.
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关键词
Dolor postoperatorio,Guías de práctica clínica,Estudio observacional antes-después
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