Pain as­ses­sment of surgical wounds after angio-surgical interventions


Authors: P. Juřeníková 1;  T. Novotný 2;  R. Staffa 2;  M. Krejčí 2
Authors‘ workplace: Katedra ošetřovatelství a porodní asistence, LF MU, Brno 1;  II. chirurgická klinika, Centrum cévních onemocnění, LF MU a FN u sv. Anny v Brně 2
Published in: Cesk Slov Neurol N 2019; 82(Supplementum 1): 44-46
Category: Original Paper
doi: 10.14735/amcsnn2019S44

Overview

Aim: The aim of the prospective study was to analyze the intensity of pain after surgery, perception of discomfort and post-operative pain, and the over­all life feelings related to the intervention treatment.

Patients and methods: The sample comprised 76 patients who had been admitted and underwent a vascular surgical procedure of an abdominal aortic aneurysm /  iliac aneurysm (21.05%), femoral/ popliteal aneurysm (23.68%), aortoiliac occlusive dis­ease (3.95%), and infrainguinal occlusive dis­ease (51.32%). The patients evaluated the pain intensity, discomfort of the pain, and the over­all life feelings on a Visual Analogue Scale. The scale as­ses­sment was tested on 0– 7th day post-operatively through the Fisher‘s exact test, the chi-squared test was used for the gender, age, dia­gnosis, surgery type, anesthesiology risk, comorbidity, and complications related to the surgical intervention. A 5% level of significance was used for the testing.

Results: When as­ses­s­­ing the pain intensity, discomfort of pain, and the perception of over­all life feelings, there was find a significant dif­ference in relation with the type of the surgical intervention, dia­gnosis.

Conclusion: Pain management is an important part of post-operative care. A systematic pain as­ses­sment is neces­sary to manage the pain appropriately. The highest intensity of pain was measured in patients after redo surgery, the worst discomfort and overall feeling were recorded in patients after abdominal aortic/pelvic artery aneurysm resection, while the highest intensity of pain and the worst overall feeling were measured in the first postoperative days with decreasing tendency over the time.

Keywords:

pain assessment – post-operative pain – surgical wound – angio-surgical intervention


Sources

1. Juřeníková P, Novotný T, Staf­fa R et al. Vybraná perioperační problematika cévněchirurgických pa­cientů. 1. vyd. Brno: Masarykova univerzita 2018.

2. Gan TJ, Habib TE, Mil­ler W et al. Apfelbaum incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin 2014; 30(1): 149– 160. doi: 10.1185/ 03007995.2013.860019.

3. Gerbershagen HJ, Aduckathil S, van Wijck AJ et al. Meis­sner pain intensity on the first day after surgery: a prospective cohort study compar­­ing 179 surgical procedures. Anesthesiology 2013; 118(4): 934– 944. doi: 10.1097/ ALN.0b013e31828866b3.

4. Castle NG, Engberg J. Further examination of the influence of caregiver staf­f­­ing levels on nurs­­ing home quality. Gerontologist 2008; 48(4): 464– 476. doi: 10.1093/ geront/ 48.4.464.

5. Chapman RC, Donaldson WG, Davis JJ et al. Improv­­ing individual measurement of postoperative pain: the pain trajectory. J Pain 2011; 12(2): 257– 262. doi: 10.1016/ j.jpain.2010.08.005.

6. Huskis­son EC. Measurement of pain. Lancet 1974; 2: 1127– 1131. doi: 10.1016/ s0140-6736(74)90884-8.

7. Price DD, Harkins SW. The af­fective-motivational dimension of pain: a two stage model. Am Pain Soc J 1992; 1: 229– 239.

8. Childs JD, Piva SR, Fritz JM. Responsiveness of the numeric pain rat­­ing scale in patients with low back pain. Spine (Phila Pa 1976) 2005; 30(11): 1331– 1334.

9. Knotek P, Šolcová I, Žalský M. Česká verze krátké formy Dotazníku bolesti McGil­lovy Univerzity: restandardizace. Bolest 2002; 5(3): 169– 172.

10. Hlinková1 E, Nemcová J, Simová A et al. The factors of pres­sure ulcer’s heal­­ing in critical­ly ill patients. Cesk Slov Neurol N 2018; 81/ 114 (Suppl 1): S13– S18. doi: 10.14735/ amcsn­n2018S13.

11. Glaser R, Kiecolt-Glaser JK, Marucha PT et al. Stres­s--related changes in proinflam­matory cytokine production in wounds. Arch Gen Psychiatry 1999, 56(5): 450– 456.

12. Kiecolt-Glaser JK, Marucha PT, Malarkey WB et al. Slow­­ing of wound heal­­ing by psychological stres­s. Lancet 1995; 346(8984): 1194– 1196. doi: 10.1016/ s0140-6736(95)92899-5.

13. Marucha PT, Kiecolt-Glaser JK, Favagehi M. Mucosal wound heal­­ing is impaired by examination stres­s. Psychosom Med 1998; 60(3): 362– 365.

14. Padgett DA, Marucha PT, Sheridan JF. Restraint stress slows cutaneous wound heal­­ing in mice. BrainBehav Im­mun 1998; 12(1): 64– 73. doi: 10.1006/ brbi.1997.0512.

15. Page GG, Ben-Eliyahu S. The im­mune-suppres­sive nature of pain. Semin Oncol Nurs 1997; 13(1): 10– 15.

16. McGuire L, Hef­fner K, Glaser R et al. Pain and wound heal­­ing in surgical patients. Ann Behav Med 2006; 31(2): 165– 172. doi: 10.1207/ s15324796abm3102_8.

17. Taylor A, Stanbury L. A review of postoperative pain management and the chal­lenges. Curr Anaesth Crit Care 2009; 20(4): 188– 194. doi: 10.1016/ j.cacc.2009.02.003.

18. van Dijk, WJ, Vervoort SC, van Wijck AJ et al. Postoperative patients’ perspectives on rat­­ing pain: a qualitative study. J Nurs Stud 2016; 53: 260– 269. doi: 10.1016/ j.ijnurstu.2015.08.007.

19. Meis­sner W, Coluzzi F, Fletcher D et al. Improv­­ing the management of post-operative acute pain: priorities for change. Curr Med Res Opin 2015; 31(11): 2131– 2143. doi: 10.1185/ 03007995.2015.1092122.

20. Ahlers SJ, van Gulik L, van der Veen AM et al. Comparison of dif­ferent pain scor­­ing systems in critical­ly ill patients in a general ICU. Crit Care 2008; 12(1): R15. doi: 10.1186/ cc6789.

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Paediatric neurology Neurosurgery Neurology

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