Gestión del dolor de niños y adolescentes durante el período post- trasplante de células-tronco hematopoyéticas: una revisión integradora

Abstract

Este estudo teve como objetivo identificar, em produções científicas, as estratégias utilizadas para o gerenciamento da dor de crianças e adolescentes no período pós-transplante de células-tronco hematopoéticas. Para tanto, utilizou-se como metodologia a revisão integrativa da literatura a partir das seguintes fontes de informação: MEDLINE, LILACS, ScIELO, BDENF, SCOPUS, Web of Science e Plataforma de periódicos CAPES. Os descritores utilizados para a busca foram: pain, pain management; pain pediatric; hematopoietic stem cell transplantation; bone marrow transplantation; e as siglas BMT e HSCT. A amostra final foi constituída por sete artigos científicos, com base nos critérios de inclusão e exclusão. As estratégias de gerenciamento da dor identificadas nos estudos foram: analgesia controlada pelo paciente, analgesia controlada pelo cuidador; terapias complementares, tais como: aromaterapia; fototerapia extra oral com diodos infravermelhos; aplicação de calor; crioterapia; música, jogos, massagem; e indicadores de resultados para monitorar a eficácia do gerenciamento da dor. Concluiu-se que as estratégias mais eficazes foram: analgesia controlada pelo paciente ou cuidador e o indicador de resultados que possibilitou o controle da dor em tempo hábil. Não obstante, é importante ressaltar que outros estudos são necessários para avaliar a eficácia das estratégias complementares citadas. Este estudio tuvo como objetivo identificar, en producciones científicas, las estrategias utilizadas en la gestión del dolor de niños y adolescentes durante el período post trasplante de células-tronco hematopoyéticas. Para ello, utilizó como metodología la revisión integradora de la literatura a partir de las siguientes fuentes de información: MEDLINE, LILACS, ScIELO, BDENF, SCOPUS, Web of Science y Plataforma de periódicos CAPES. Se utilizó como descriptores: pain, pain management; pain pediatric; hematopoietic stem cell transplantation; bone marrow transplantation; y las siglas BMT e HSCT. La muestra final fue constituida por siete artículos científicos, a partir de los criterios de inclusión y exclusión. Las estrategias para la gestión del dolor identificadas en los estudios fueron: analgesia controlada por el paciente, analgesia controlada por el cuidador; terapias complementarias, tales como: aromaterapia; fototerapia extra oral con diodos infrarrojos; aplicación de calor; crioterapia; música, juegos, masaje; e indicadores de resultados para medir la eficacia de la gestión del dolor. La conclusión es que las estrategias más eficaces fueron: analgesia controlada por el paciente o cuidador y el indicador de resultados que posibilitó el control del dolor en tiempo hábil. Sin embargo, es necesario hacer hincapié en la importancia de invertir en otros estudios para evaluación de la eficacia de dichas estrategias complementarias. This study aims at the identification of strategies used for pain management in children and teenagers during the hematopoietic stem cells post-transplant period. An integrative review of literature was employed as methodology for this work, using as sources of information the following databases: MEDLINE, LILACS, SCIELO, BDENF, SCOPUS, Web of Science and CAPES periodic portal. The terms used for searching were: pain, pain management, pain pediatric, hematopoietic stem cell transplantation, bone marrow transplantation; and the acronyms BMT and HSCT. The final sample comprised seven articles, based on inclusion and exclusion criteria. The identified strategies for pain management in the studies were: patient-controlled analgesia, caregiver-controlled analgesia; complementary therapies such as: aromatherapy, extra-oral phototherapy with infrared diodes, heat application, cryotherapy, music, games, massage; and results indicators, in order to monitor the pain management effectiveness. As a conclusion, the most effective strategies were: patient or caregiver-controlled analgesia, and the results indicators that allowed pain management in adequate time. Nevertheless, it is important to highlight that other studies are necessary to evaluate the effectiveness of the complementary strategies employed.

Nursing diagnosis after hematopoietic stem cell transplant due to Fanconi anemia

“…In a study with post-transplant children and adolescent, pain was found to be the most frequent and debilitating symptom in the context of HPST (24) , and, in this study, it was mostly associated with oral mucositis, although it was also related with abdominal pain, to the insertion of the semi-implanted central venous catheter (SICVC), and to the graft-versus-host disease (GVHD). These results are similar to the findings of another study with a similar population, which showed that the pain of patients who underwent HPST became worse due to chemotherapy side effects and to acute complications after the transplant, such as: gastrointestinal complications, oral mucositis, veno-occlusive disease, and GVHD (25) .…”

Effects of Cancer Treatment on the Comfort of Children and Adolescents with Cancer: A Scoping Review

“…Likewise, other evidence reports that the pain experienced by children and adolescents with cancer causes an unpleasant sensation, of a multi-factor origin, which is difficult to manage, and may lead to physical and emotional changes (11,12,39). Thus, the management of pain represents a challenge for professionals who work in the area, especially in its identification and management prior to the cancer treatment to which this population is submitted (13)(14)(15)39).…”