A dor interfere na função respiratória após cirurgias cardíacas?

Sasseron, Ana Beatriz; Figueirêdo, Luciana Castilho de; Trova, Kerolin; Cardoso, Andréa Luciana; Lima, Núbia Maria Freire Vieira; Olmos, Sarita Colasanto; Petrucci, Orlando

doi:10.1590/s0102-76382009000500010

Cited by 44 publications

(25 citation statements)

References 17 publications

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“…Possible reasons for the lower levels of pain could be an individual pain relief strategy, deep breathing exercises with PEP directly after extubation, or early mobilisation. The association between decreases in lung volumes and high pain levels, that is, patients with more pain had the greatest decrease in lung volume, is in accordance with other results [22, 30]. …”

Section: Discussionsupporting

confidence: 92%

“…Nicholson et al [5] reported a mean reduction of approximately 40–50% in FEV 1 and FVC on the first and third postoperative day, and Matte et al [6] reported a reduction of 53% (VC) on the first postoperative day and 63% on the second postoperative day. The causes of reduced lung volumes are probably multifactorial and may involve a combination of surgery, anaesthesia, immobilisation, and pain [22]. Reduced lung volumes affect gas exchange and an inverse correlation between atelectatic area and arterial oxygenation (PaO 2 ) during the first postoperative days after open-heart surgery have been described [8, 10].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Lung Function before and Two Days after Open-Heart Surgery

Urell

Westerdahl

Hedenström

et al. 2012

Critical Care Research and Practice

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Reduced lung volumes and atelectasis are common after open-heart surgery, and pronounced restrictive lung volume impairment has been found. The aim of this study was to investigate factors influencing lung volumes on the second postoperative day. Open-heart surgery patients (n = 107, 68 yrs, 80% male) performed spirometry both before surgery and on the second postoperative day. The factors influencing postoperative lung volumes and decrease in lung volumes were investigated with univariate and multivariate analyses. Associations between pain (measured by numeric rating scale) and decrease in postoperative lung volumes were calculated with Spearman rank correlation test. Lung volumes decreased by 50% and were less than 40% of the predictive values postoperatively. Patients with BMI >25 had lower postoperative inspiratory capacity (IC) (33 ± 14% pred.) than normal-weight patients (39 ± 15% pred.), (P = 0.04). More pain during mobilisation was associated with higher decreases in postoperative lung volumes (VC: r = 0.33, P = 0.001; FEV1: r = 0.35, P ≤ 0.0001; IC: r = 0.25, P = 0.01). Patients with high BMI are a risk group for decreased postoperative lung volumes and should therefore receive extra attention during postoperative care. As pain is related to a larger decrease in postoperative lung volumes, optimal pain relief for the patients should be identified.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Lung Function before and Two Days after Open-Heart Surgery

Urell

Westerdahl

Hedenström

et al. 2012

Critical Care Research and Practice

View full text Add to dashboard Cite

show abstract

“…Pain management after cardiac surgery is very important to enhance the deep breathing, coughing, and early ambulation which are critical for respiratory care, early recovery and prognosis (1, 2, 3). Although pain after cardiac surgery is less than upper abdominal surgery and thoracotomy as less muscle division is required during median sternotomy (4), the sternal splitting causes significant pain.…”

Section: Introductionmentioning

confidence: 99%

Application of Lidocaine Jelly on Chest Tubes to Reduce Pain Caused by Drainage Catheter after Coronary Artery Bypass Surgery

et al. 2014

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The objective of this study was to assess the effect of lidocaine jelly application to chest tubes on the intensity and duration of overall pain, chest tube site pain and the required analgesics for postoperative pain relief in coronary artery bypass graft (CABG) patients. For patients in group L, we applied sterile 2% lidocaine jelly on the chest tubes just before insertion, and for patients in group C, we applied normal saline. Overall visual analogue scale (VAS), maximal pain area with their VAS were documented postoperatively, and the frequency that button of patient-controlled analgesia was pressed (FPB) and total fentanyl consumption were assessed. The number of patients who complained that tube site was the most painful site was significantly higher in group C than in group L (85% vs. 30% at extubation, P<0.001). The overall VAS score was significantly higher in group C than in group L (39.14±12.49 vs. 27.74±13.76 at extubation, P=0.006). After all of the tubes were removed, the VAS score decreased more in group C (5.74±4.77, P<0.001) than in group L (3.05±2.48, P<0.001). FPB and total fentanyl consumption were significantly higher in group C than in group L (73.00, 59.00-78.00 vs. 34.00, 31.00-39.25, P<0.001; 2,214.65±37.01 vs. 1,720.19±361.63, P<0.001, respectively). Lidocaine jelly application is a very simple way to reduce postoperative pain by reducing chest tube site pain after CABG. (Clinical Trials Registry No. ACTRN 12611001215910)

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“…This is present even before the surgery and it is important in respiratory function in the postoperative period, which may aggravate bronchial hygiene. These findings lead us to develop different strategies in the treatment of pain and physical therapy that might interfere with pain, with consequent improvement in lung function [15].…”

Section: Introductionmentioning

confidence: 99%

“…The transcutaneous electrical nerve stimulation (TENS) is a physical therapy feature widely used for symptomatic relief of pain and it can be a useful adjunct in the management of postoperative pain [11][12][13][14][15][16]. This form of stimulation does not produce systemic effects, it is not invasive or pharmacological, it is not addictive, nor does it have side effects and absolute contraindications it is a lowcost procedure, in addition to allow the patient to participate more completely in physical therapy [11 , 17].…”

Section: Introductionmentioning

confidence: 99%