scholarly journals Pain management in intensive care unit patients after cardiac surgery with sternotomy approach

2019 ◽  
Vol 26 (1) ◽  
pp. 51-63
Author(s):  
Baiba Vilīte ◽  
Eva Strīķe ◽  
Katrīna Rutka ◽  
Roberts Leibuss
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Patient Satisfaction ◽  
Pain Management ◽  
Postoperative Pain ◽  
Pharmacological Treatment ◽  
Pharmacological Therapy ◽  
Cross Sectional ◽  
Intensive Care Patients ◽  
Vas Score

Background. Postoperative pain is a common problem among intensive care patients. Pain management includes pain assessment and documentation, patient care, and pharmacological treatment. Materials and methods. The study used a prospective, cross-sectional design. Nineteen intensive care nurses and 72 intensive care patients after cardiac surgery with sternotomy approach were studied. Toronto Pain Management Inventory was used to assess nurses and the 2010 Revised American Pain Society Patient Outcome Questionnaire was used to assess the patients. A research protocol was used to document pharmacological treatment data and Visual Analog Scale (VAS) pain measurements. The pharmacological therapy data was available for 72 patients, but patient satisfaction measurements were acquired from 52 patients. Results. Postoperative pain for intensive care patients after cardiac surgery is mostly mild (68.66%). Pain intensity had a tendency to decrease over time, from a mean VAS score of 4.66 two hours after extubation to a mean VAS score of 3.12 twelve hours after extubation. Mostly opioids (100%) and nonsteroidal anti‑inflammatory drugs (NSAIDs, 77.8%) were used for pharmacological treatment, and treatment was adjusted according to pain levels and patient needs. Patient satisfaction regarding pain management in the first 24 hours after surgery was high (94.2%), even though the nurses’ pain knowledge was average (X = 60.6 ± 7.3%). Conclusions. An individualized pain management plan requires pain documentation and ensures high patient satisfaction. Pain levels after cardiac surgery with sternotomy approach are mostly mild and patient satisfaction is high.

scholarly journals Adherence to All Steps of a Pain Management Protocol in Intensive Care Patients after Cardiac Surgery Is Hard to Achieve

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
L. van Gulik ◽  
S. J. G. M. Ahlers ◽  
P. Bruins ◽  
D. Tibboel ◽  
C. A. J. Knibbe ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Pain Management ◽  
Side Effects ◽  
Good Adherence ◽  
Intensive Care Patients ◽  
Morphine Infusion ◽  
Pain Scores ◽  
Management Protocol

Purpose.To investigate adherence to our pain protocol considering analgesics administration, number and timing of pain assessments, and adjustment of analgesics upon unacceptably high (NRS ≥ 4) and low (NRS ≤ 1) pain scores.Material and Methods.The pain protocol for patients in the intensive care unit (ICU) after cardiac surgery consisted of automated prescriptions for paracetamol and morphine, automated reminders for pain assessments, a flowchart to guide interventions upon high and low pain scores, and reassessments after unacceptable pain.Results.Paracetamol and morphine were prescribed in all 124 patients. Morphine infusion was stopped earlier than protocolized in 40 patients (32%). During the median stay of 47 hours [IQR 26 to 74 hours], 702/706 (99%) scheduled pain assessments and 218 extra pain scores were recorded. Unacceptably high pain scores accounted for 96/920 (10%) and low pain scores for 546/920 (59%) of all assessments. Upon unacceptable pain additional morphine was administered in 65% (62/96) and reassessment took place in 15% (14/96). Morphine was not tapered in 273 of 303 (90%) eligible cases of low pain scores.Conclusions.Adherence to automated prescribed analgesics and pain assessments was good. Adherence to nonscheduled, flowchart-guided interventions was poor. Improving adherence may refine pain management and reduce side effects.

scholarly journals Nurses’ use of non-pharmacological pain management methods in intensive care units: A descriptive cross-sectional study

2021 ◽  
Vol 58 ◽  
pp. 102705
Author(s):  
Zeinab Kia ◽  
Maryam Allahbakhshian ◽  
Mahnaz Ilkhani ◽  
Malihe Nasiri ◽  
Atefeh Allahbakhshian
Keyword(s):  
Intensive Care ◽  
Pain Management ◽  
Intensive Care Units ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Efficacy of bilateral pectoralis nerve block for ultrafast tracking and postoperative pain management in cardiac surgery

2018 ◽  
Vol 21 (3) ◽  
pp. 333 ◽  
Author(s):  
PS Nagaraja ◽  
KarthikNarendra Kumar ◽  
RavikumarNagashetty Kalyane ◽  
NaveenG Singh ◽  
Madhu Krishna ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Pain Management ◽  
Postoperative Pain ◽  
Nerve Block ◽  
Postoperative Pain Management

scholarly journals Utilization of Non-Pharmacological Methods and the Perceived Barriers for Adult Postoperative Pain Management by the Nurses at Selected National Hospitals in Asmara, Eritrea

2020 ◽  
Author(s):  
Betiel Yihdego Kidanemariam ◽  
Traudl Elsholz ◽  
Laban L. Simel ◽  
Eyasu H. Tesfamariam ◽  
Yonatan Mehari Andemeskel
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Health Care Providers ◽  
Work Experience ◽  
Statistical Significance ◽  
Demographic Data ◽  
Postoperative Pain Management ◽  
Perceived Barriers ◽  
Care Providers ◽  
Cross Sectional

Abstract Background: Pharmacological methods are widely used for postoperative pain management however, poorly controlled pain continues to pose a significant challenge. Non pharmacological methods could contribute to the unresolved postoperative pain management in assisting nurses’ routine care and reducing the need for medication. This study aimed to assess nurses’ utilization of non-pharmacological methods in postoperative pain and the perceived barriers for their implementation at the National Hospitals.Methods: This was a descriptive cross sectional study conducted among 154 nurses working at the National Referral Hospitals and Sembel Private Hospital. A standardized five-point Likert-scale questionnaire which assesses nurses' utilization of selected non-pharmacological methods and the perceived barriers for the implementation was used to collect data. Descriptive statistics for the demographic data, independent samples t-test, one way ANOVA and factorial ANOVA were used to analyze the data. Statistical significance level was set at P < 0.05.Results: The study found out that emotional support (45.5%), helping with daily activities (67.5%) and creating a comfortable environment (61%) were mostly used while, cognitive-behavioral (5.9%) and physical methods (5.8%) were hardly used. The results also showed that, characteristics such as, age (p=0.013), level of education (p=0.012), work experience (p=0.001) and place of work (p=0.001), were significantly related to the use of non-pharmacological methods at bivariate level. However, hospitals were the only determinants of the non-pharmacological methods at multivariable level with a statistical significance of (p<0.001). On the perceived barriers; heavy work load (87.7%), shortage of time (84.4%), limited resources (82.5%), deficit in the guidelines for pain management (77.3%), patient’s uncooperative behavior (57.1%), language difference (64.4%), nurse’s lack of knowledge (50%) and experience (40.3%) were identified.Conclusion: The use of non-pharmacological methods in the studied hospitals varied greatly on the knowledge and experience of the nurses. Therefore, it is recommended that exposure and training for all health care providers at all level is a paramount importance in order to appreciate the benefits of non-pharmacological methods applicable to postoperative pain management. This could be achieved through on job training, seminars, scientific conferences and other brainstorming forums.

scholarly journals Pharmacological analgesia in neonates undergoing cardiac surgery

2008 ◽  
Vol 16 (4) ◽  
pp. 727-732 ◽  
Author(s):  
Mariana Bueno ◽  
Amélia Fumiko Kimura ◽  
Cibele Andrucioli de Mattos Pimenta
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Pain ◽  
Pain Control ◽  
Private Hospital ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Postoperative Pain Control ◽  
Fentanyl Citrate ◽  
Cross Sectional ◽  
The City

The objectives of this study were to verify the frequency of pharmacological analgesia and the occurrence of postoperative pain in neonates undergoing cardiac surgery. METHODS: This is a cross-sectional study and data were collected from 30 medical charts of neonates who underwent cardiac surgery in a private hospital in the city of São Paulo. RESULTS: The majority (96.6%) of neonates received analgesia: 18 (60.0%) received continuous analgesics, five (16.7%) received intermittent drugs, and six (20.0%) received a combination of continuous and intermittent analgesics. Fentanyl citrate was continuously administered to 24 (80.0%) neonates. Intermittent dipyrone and morphine was administered to ten (33.3%) and one (3.3%) neonates, respectively. Pain registers were observed in 17 (56.7%) medical charts and the occurrence of pain among neonates who received analgesics was 53.4%. CONCLUSION: There was no efficacy in pharmacological postoperative pain control in the neonates included in this study.

scholarly journals Acute Pain Management in Intensive Care Patients: Facts and Figures

2018 ◽  
Author(s):  
Nissar Shaikh ◽  
Saher Tahseen ◽  
Qazi Zeesan Ul Haq ◽  
Gamal Al-Ameri ◽  
Adel Ganaw ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pain Management ◽  
Acute Pain ◽  
Acute Pain Management ◽  
Intensive Care Patients
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