Pain Intensity on the First Day after Surgery

Abstract

Background: Severe pain after surgery remains a major problem, occurring in 20-40% of patients. Despite numerous published studies, the degree of pain following many types of surgery in everyday clinical practice is unknown. To improve postoperative pain therapy and develop procedurespecific, optimized pain-treatment protocols, types of surgery that may result in severe postoperative pain in everyday practice must first be identified. Methods: This study considered 115,775 patients from 578 surgical wards in 105 German hospitals. A total of 70,764 patients met the inclusion criteria. On the first postoperative day, patients were asked to rate their worst pain intensity since surgery (numeric rating scale, 0-10). All surgical procedures were assigned to 529 well-defined groups. When a group contained fewer than 20 patients, the data were excluded from analysis. Finally, 50,523 patients from 179 surgical groups were compared. Results: The 40 procedures with the highest pain scores (median numeric rating scale, 6-7) included 22 orthopedic/trauma procedures on the extremities. Patients reported high pain scores after many "minor" surgical procedures, including appendectomy, cholecystectomy, hemorrhoidectomy, and tonsillectomy, which ranked among the 25 procedures with highest pain intensities. A number of "major"

Postoperative Pain Assessment Indices Based on Photoplethysmography Waveform Analysis

“…Up to 50% of surgical patients are known to experience moderate or even severe pain immediately after surgery (Boselli et al, 2013; Gerbershagen et al, 2013). While opioids are widely used as effective analgesics, opioid sensitivity is well known to vary widely among individuals.…”

Abordagem da Dor em Dermatologia (Parte I)

“…A dor pós-operatória é um sintoma frequentemente subvalorizado 41 e subtratado. 42 O controlo inadequado da dor aumenta o risco de complicações no período pós-operató-rio, reduz a satisfação do doente e compromete a adesão a tratamentos futuros, além de ser um fator de risco para a cronificação da dor.…”

“…A incidência de dor pós-operatória não controlada foi superior em procedimentos minor (o que engloba a maioria dos procedimentos dermatológicos) em comparação com intervenções major, o que pode refletir a perceção incorreta que este tipo de procedimentos são indolores. 41 Beiteke et al encontraram resultados similares em doentes submetidos a dermatocirurgia oncológica, reportando taxas de dor pós-operatória surpreendentemente elevadas. Os valores mais altos referem-se à cirurgia do carcinoma basocelular.…”

Abordaje del dolor agudo en traumatología

“…Las intervenciones de traumatología y cirugía ortopédica están entre las que más dolor provocan (13). Además, ha quedado establecido que la presencia de un dolor agudo intenso es un factor de riesgo para desarrollar dolor crónico (14,15) que interfiere con las actividades de la vida diaria, provoca pérdida de empleos y disminución de sus posibilidades profesionales y laborales (16), siendo un problema económico de primer orden (17).…”