Background: Pain is a public health problem that affects the quality of life of hospitalized patients, with prevalence between 30-70%. Therefore, it is relevant to determine the prevalence, intensity and pain interference in hospitalized patients at the Clínica Reina Sofia in Bogotá. Methodology: A descriptive cross-sectional study was carried out, 360 patients > 18 years were included, with hospitalization greater than 24 hours. The instrument BPI-sf was applied, the analgesic treatment at the time of the survey was recorded. Patients in obstetric services, intensive care and those with inability to communicate were excluded. Additionally, we used the term "great interference" to activities scored with value ≥ 8. The study was approved by the ethics committee of the institution. Results: The prevalence of pain was 67.5%. The mean current pain intensity was 3.4 (±2.7) and mean interference was 4.7 (±3.8). No statistically significant differences by gender or type of service in pain intensity and interference were found. Assessing the relationship with intensity, walk was positively correlated with current pain (ρ: 0.35 p = < 0,001). The multimodal analgesia was the method most commonly used, however 23.0% of patients with pain did not received analgesics. Discussion: Because the prevalence of pain is high, it is important to strengthen strategies to identify and treat pain promptly, based on education of paramedical personnel in the active search for patients with pain and identify pain as a fifth vital sign.
Ultralow doses of naloxone (0.001-0.1 microg/kg) produce analgesia in animal models. However, no clinical study has evaluated the combination of ultralow dose naloxone and morphine using patient-controlled analgesia (PCA). This randomized, double blind controlled study sought to determine if the combination of ultralow dose naloxone and morphine in PCA solutions affects opioid requirements, analgesia, and side effects. Two-hundred and sixty-five patients (18-65 years old) undergoing operations were randomized to receive PCA morphine 1 mg/ml (n=129) or PCA morphine 1 mg/ml plus naloxone 0.6 microg/ml (n=136). We evaluated the numbers of supplemental rescue doses, the cumulative dose of each PCA solution, pain intensity, pain relief, and opioid side effects during the first 24 h after surgery. We found that opioid requirements did not differ significantly between groups. The morphine+naloxone group on average required 0.07 mg more morphine (95% CI -1.1 to 1.3) during the 24 h than the morphine group. Pain intensity levels were also similar in both groups. The morphine+naloxone group had 0.06 units lower (95% CI -0.5 to 0.4) pain intensity levels than the morphine group. The morphine+naloxone group had a lower incidence of nausea and pruritus than the morphine group (P=0.01 for both symptoms). However, the incidence of vomiting, time to tolerate fluids, sedation, and urinary retention were similar between groups (all P values >0.1). The combination of ultralow dose naloxone and morphine in PCA does not affect analgesia or opioid requirements, but it decreases the incidence of nausea and pruritus.
La prevalencia de dolor en pacientes de Clínica Colsanitas es importante y se encuentra dentro de lo reportado internacionalmente. Dentro de las estrategias para disminuir el dolor y mejorar la atención de los pacientes se encuentra la Política de hospital sin dolor y protocolos de manejo de dolor en situaciones específicas. El presente artículo resume las directrices del protocolo de manejo analgésico de pacientes con dolor agudo (diferente al dolor postoperatorio y al dolor crónico) durante su estancia hospitalaria, con el propósito de promover el uso seguro de los analgésicos y aportar al valor corporativo de la compasión.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.