Mensuração e características da dor perineal em primíparas submetidas à episiotomia

Abstract

OBJETIVO: Mensurar e caracterizar a percepção dolorosa das puérperas primíparas submetidas à episiotomia. MÉTODOS: Trata-se de uma pesquisa descritiva com abordagem quantitativa, realizada com 40 puérperas primíparas submetidas ao parto normal com episiotomia. Para mensuração da dor foi utilizada a escala de categoria numérica e para caracterização a versão brasileira do questionário McGill - Br-MPQ. RESULTADOS: Os valores encontrados na avaliação da dor foram de média 4,2 e os descritores que melhor caracterizaram a dor foram: dolorida; que repuxa; incômoda; chata; ardida; pica como uma agulhada; latejante; em pressão. CONCLUSÃO: A intensidade da dor perineal foi considerada como moderada pelas puérperas. Na caracterização da queixa dolorosa os descritores mais citados foram da dimensão sensorial. Este estudo possibilitou observar a necessidade do reconhecimento dos aspectos qualitativos e quantitativos da dor na prática clinica obstétrica.

Episiotomy: perceptions from adolescent puerperae

“…12 The pain in the postpartum period, despite being the main complaint and the most frequent morbidity resulting from the delivery process, is undervalued by professionals and even by the woman and their families because of the attention directed to the newborn. 1,12 Corroborating the findings of the current study, the subordination of women in relation to the trader decision, especially the doctor on the episiotomy is something documented in other studies. Authors report that the woman even not receiving appropriate clarification and not being consulted during the decision to hold or not the procedure takes as normal and necessary medical decisions.…”

“…The episiotomy is defined as the injury resulting from surgical enlargement of the vaginal opening by making an incision in the perineum in normal delivery assistance. 1 Against the recommendations of the World Health Organization (WHO) that episiotomy is a procedure that should be avoided, 2 this intervention is still practiced routinely, especially in primiparous and parturients undergoing the procedure previously due to the lack of protocols of establishment or sole criteria, the interventionist care model widespread in university schools and disputes among authors, government agencies, health care institutions beyond the experience of each professional. 3 The Ministry of Health does not provide an ideal percentage of practice of incision, but it is believed that this should be between 10 to 30% of the nearly 1.4 million vaginal births each year in Brazil.…”

“…As a result, the nurse, characterized in being less interventionist compared to the doctors, is performing episiotomy in similar proportions to the other professionals. 1,3,8 A study conducted between 1983 and 2012 in order to characterize the scientific production of a nursing magazine revealed that the practice of nursing, a category where one might find episiotomy was subject of study in only 6% of the articles. 9 In this context, the motivation for this study took place from the perception that the existing literature approaches the episiotomy theme, most of the time, just like surgical procedure in their technical and scientific aspects, clinical and biological and little discusses the vision of pregnant women.…”

Perineal pain measurement in the immediate vaginal postpartum period

“…It is made up of a horizontal line with numbers from zero to 10 and on its edges there are the following expressions: "no pain" (zero) and "unbearable pain" (10). Participants should mark in the line the number corresponding to their pain and the higher the score the higher the intensity of pain 17 . Patients were evaluated only once with a minimum of 6h and maximum of 24h after delivery.…”

“…This period was related, respectively, to the moment women could already leave bed and end of analgesia, in case it had been used; and limit of 24h, related to injury acute phase, inflammatory process and higher predominance of pain. In case mothers had used some pain relief resource, the period of its effect was controlled based on drug dose, thus considering possible interferences with initial pain evaluation [17][18][19] . Data were collected by two duly trained evaluators who made jointly evaluations.…”