Dor persistente pós-operatória em cirurgias cardíacas e fatores de risco associados: estudo prospectivo observacional
Autor(a) principal: | |
---|---|
Data de Publicação: | 2020 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional Manancial UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/22301 |
Resumo: | Introduction: Persistent postoperative pain (DPPO) is a consequence of the surgical procedure and has aroused great interest in health professionals due to the losses and difficulties in treatment and its high cost. Among surgical procedures, cardiac surgery is especially important because it has a high incidence and generates an extremely high preoperative anxiety level. The mechanisms of postoperative pain persistence are complex and not fully understood. Objective: The present study aims to assess the incidence of DPPO in the cardiac surgery service of HUSM (Hospital Universitário de Santa Maria-RS), as well as the identification of risk factors for development. Methodology: A prospective observational study was performed, using a collection instrument, in patients undergoing cardiac surgery with sternotomy at the HUSM during 12 months with the expectation of capturing 103 patients, according to inclusion and exclusion factors. In order to highlight the influence of psychosocial factors on acute pain, anxiety was assessed using the HADS A scale, depression, in turn, was assessed using the HADS D scale and negative beliefs and exaggerated responses using the catastrophizing scale. Results: This study showed a 57% incidence of DPPO in patients undergoing cardiac surgery with sternotomy, after 3 months. Significant correlation was identified between anxiety profile (p=0.003), pain at 48h (p=0.022), previous psychic disorders (p=0.044), previous use of medications antidepressants (p=0.027) and the development of DPPO. The most significant variables for DPPO logistic regression in relation to the scales, from the determination of the adjusted OR, Were HADS A (p=0.015) presenting 10.93 times more chance of presenting chronic pain, Pain at 48 hours (p=0.009) with 2.79 more chance of progressing to DPPO and with 5.04 greater chance of presenting DPPO due to the use of antidepressants (p=0.041).Conclusion: Based on the results obtained, it is possible to associate risk factors such as anxiety and catastrophization to the development of DPPO, compared to the population studied. It is worth mentioning that the correct identification and treatment of AD and subacute are important factors to be evaluated during the anamnesis of patients who underwent cardiac surgery with sternotomy, in order to reduce the progression of the condition to DPPO, as pain in 48 hours after the procedure is also showed a risk factor. In addition, the fact of using antidepressants brings greater chances of developing DPPO, according to this study. |
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2021-09-29T18:20:06Z2021-09-29T18:20:06Z2020-10-30http://repositorio.ufsm.br/handle/1/22301Introduction: Persistent postoperative pain (DPPO) is a consequence of the surgical procedure and has aroused great interest in health professionals due to the losses and difficulties in treatment and its high cost. Among surgical procedures, cardiac surgery is especially important because it has a high incidence and generates an extremely high preoperative anxiety level. The mechanisms of postoperative pain persistence are complex and not fully understood. Objective: The present study aims to assess the incidence of DPPO in the cardiac surgery service of HUSM (Hospital Universitário de Santa Maria-RS), as well as the identification of risk factors for development. Methodology: A prospective observational study was performed, using a collection instrument, in patients undergoing cardiac surgery with sternotomy at the HUSM during 12 months with the expectation of capturing 103 patients, according to inclusion and exclusion factors. In order to highlight the influence of psychosocial factors on acute pain, anxiety was assessed using the HADS A scale, depression, in turn, was assessed using the HADS D scale and negative beliefs and exaggerated responses using the catastrophizing scale. Results: This study showed a 57% incidence of DPPO in patients undergoing cardiac surgery with sternotomy, after 3 months. Significant correlation was identified between anxiety profile (p=0.003), pain at 48h (p=0.022), previous psychic disorders (p=0.044), previous use of medications antidepressants (p=0.027) and the development of DPPO. The most significant variables for DPPO logistic regression in relation to the scales, from the determination of the adjusted OR, Were HADS A (p=0.015) presenting 10.93 times more chance of presenting chronic pain, Pain at 48 hours (p=0.009) with 2.79 more chance of progressing to DPPO and with 5.04 greater chance of presenting DPPO due to the use of antidepressants (p=0.041).Conclusion: Based on the results obtained, it is possible to associate risk factors such as anxiety and catastrophization to the development of DPPO, compared to the population studied. It is worth mentioning that the correct identification and treatment of AD and subacute are important factors to be evaluated during the anamnesis of patients who underwent cardiac surgery with sternotomy, in order to reduce the progression of the condition to DPPO, as pain in 48 hours after the procedure is also showed a risk factor. In addition, the fact of using antidepressants brings greater chances of developing DPPO, according to this study.e tem despertado nos profissionais da saúde grande interesse devido aos prejuízos e às dificuldades de tratamento e seu alto custo. Dentre os procedimentos cirúrgicos a cirurgia cardíaca tem importância especial por apresentar alta incidência e por gerar um nível de ansiedade pré-operatório bastante elevado. Os mecanismos da persistência de dor pós-operatória são complexos e não totalmente compreendidos. Objetivo: O presente estudo tem como objetivo avaliar a incidência de DPPO no serviço de cirurgia cardíaca do HUSM (Hospital Universitário de Santa Maria-RS), bem como a identificação de fatores de risco para o desenvolvimento. Metodologia: Foi realizado estudo de coorte prospectivo observacional, através de instrumento de coleta, em pacientes submetidos a cirurgia cardíaca com esternotomia no HUSM durante 12 meses, no qual participaram 103 pacientes, segundo fatores de inclusão e exclusão. A fim de evidenciar a influência de fatores psicossociais na dor aguda, a ansiedade foi avaliada por escala de HADS A, a depressão, por sua vez, foi avaliada por escala de HADS D e as crenças negativas e respostas exageradas por escala de catastrofização. Resultados: Este estudo apresentou uma incidência de 57% de DPPO em pacientes submetidos a cirurgia cardíaca com esternotomia, após 3 meses., Identificou-se correlação significativa entre perfil de ansiedade (p=0,003), dor nas 48h (p=0,022), transtornos psíquicos prévios (p=0,044), uso prévio de medicações antidepressivas (p=0,027) e o desenvolvimento de DPPO. As variáveis significativas durante a análise de regressão logística de DPPP em relação às variáveis estudadas, a partir da determinação do ORajustado, foram HADS A (p=0,015) apresentando 10,93 vezes mais chance de apresentar DPPO, Dor às 48h (p=0,009) com 2,79 mais chance de apresentar DPPO e o uso de antidepressivo (p=0,041) com 5,04 mais chance de apresentar DPPO. Conclusão: Dados resultados obtidos é possível associar, ante à população estudada, os fatores de risco como ansiedade e catastrofização ao desenvolvimento de DPPO. Vale ressaltar que a correta identificação e tratamento de DA e subaguda são fatores importantes a serem avaliados durante a anamnese de pacientes que passaram por cirurgia cardíaca com esternotomia, com a finalidade reduzir a evolução do quadro para DPPO, pois dor em 48h pós procedimento também se mostrou fator de risco. Além disso, o fato de fazer uso de antidepressivos traz maiores chances de desenvolver DPPO, segundo este estudo.porUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Ciências da SaúdeUFSMBrasilCiências da SaúdeAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessDor persistente pós-operatóriaCirurgia cardíacaEsternotomiaSternotomyPersistent postoperative painCardiac surgeryCNPQ::CIENCIAS DA SAUDEDor persistente pós-operatória em cirurgias cardíacas e fatores de risco associados: estudo prospectivo observacionalPersistent postoperative pain in heart surgeries and associated risk factors: observational prospective studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisMenezes, Miriam Seligman dehttp://lattes.cnpq.br/8746728488629971Weinmann, Angela Regina MacielGodoy, Maria Celoni de Mello dehttp://lattes.cnpq.br/6807977462360676Stüker, Nonie Candace400000000001600600600e450222d-aeb2-4e39-9f08-7146685167138883055b-a99b-4d91-8a48-7f54eeebd44306679244-e12d-4d8d-b33e-0c7ee8fc645f0c834401-8ad3-4af5-b101-b24d6947f5a0reponame:Repositório Institucional Manancial UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALDIS_PPGCS_2020_STUKER_NONIE.pdfDIS_PPGCS_2020_STUKER_NONIE.pdfDissertação de Mestradoapplication/pdf1156043http://repositorio.ufsm.br/bitstream/1/22301/1/DIS_PPGCS_2020_STUKER_NONIE.pdf12e0fc6512e6471f651f7f2e38314b3cMD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; 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dc.title.por.fl_str_mv |
Dor persistente pós-operatória em cirurgias cardíacas e fatores de risco associados: estudo prospectivo observacional |
dc.title.alternative.eng.fl_str_mv |
Persistent postoperative pain in heart surgeries and associated risk factors: observational prospective study |
title |
Dor persistente pós-operatória em cirurgias cardíacas e fatores de risco associados: estudo prospectivo observacional |
spellingShingle |
Dor persistente pós-operatória em cirurgias cardíacas e fatores de risco associados: estudo prospectivo observacional Stüker, Nonie Candace Dor persistente pós-operatória Cirurgia cardíaca Esternotomia Sternotomy Persistent postoperative pain Cardiac surgery CNPQ::CIENCIAS DA SAUDE |
title_short |
Dor persistente pós-operatória em cirurgias cardíacas e fatores de risco associados: estudo prospectivo observacional |
title_full |
Dor persistente pós-operatória em cirurgias cardíacas e fatores de risco associados: estudo prospectivo observacional |
title_fullStr |
Dor persistente pós-operatória em cirurgias cardíacas e fatores de risco associados: estudo prospectivo observacional |
title_full_unstemmed |
Dor persistente pós-operatória em cirurgias cardíacas e fatores de risco associados: estudo prospectivo observacional |
title_sort |
Dor persistente pós-operatória em cirurgias cardíacas e fatores de risco associados: estudo prospectivo observacional |
author |
Stüker, Nonie Candace |
author_facet |
Stüker, Nonie Candace |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Menezes, Miriam Seligman de |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/8746728488629971 |
dc.contributor.referee1.fl_str_mv |
Weinmann, Angela Regina Maciel |
dc.contributor.referee2.fl_str_mv |
Godoy, Maria Celoni de Mello de |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/6807977462360676 |
dc.contributor.author.fl_str_mv |
Stüker, Nonie Candace |
contributor_str_mv |
Menezes, Miriam Seligman de Weinmann, Angela Regina Maciel Godoy, Maria Celoni de Mello de |
dc.subject.por.fl_str_mv |
Dor persistente pós-operatória Cirurgia cardíaca Esternotomia Sternotomy |
topic |
Dor persistente pós-operatória Cirurgia cardíaca Esternotomia Sternotomy Persistent postoperative pain Cardiac surgery CNPQ::CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
Persistent postoperative pain Cardiac surgery |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE |
description |
Introduction: Persistent postoperative pain (DPPO) is a consequence of the surgical procedure and has aroused great interest in health professionals due to the losses and difficulties in treatment and its high cost. Among surgical procedures, cardiac surgery is especially important because it has a high incidence and generates an extremely high preoperative anxiety level. The mechanisms of postoperative pain persistence are complex and not fully understood. Objective: The present study aims to assess the incidence of DPPO in the cardiac surgery service of HUSM (Hospital Universitário de Santa Maria-RS), as well as the identification of risk factors for development. Methodology: A prospective observational study was performed, using a collection instrument, in patients undergoing cardiac surgery with sternotomy at the HUSM during 12 months with the expectation of capturing 103 patients, according to inclusion and exclusion factors. In order to highlight the influence of psychosocial factors on acute pain, anxiety was assessed using the HADS A scale, depression, in turn, was assessed using the HADS D scale and negative beliefs and exaggerated responses using the catastrophizing scale. Results: This study showed a 57% incidence of DPPO in patients undergoing cardiac surgery with sternotomy, after 3 months. Significant correlation was identified between anxiety profile (p=0.003), pain at 48h (p=0.022), previous psychic disorders (p=0.044), previous use of medications antidepressants (p=0.027) and the development of DPPO. The most significant variables for DPPO logistic regression in relation to the scales, from the determination of the adjusted OR, Were HADS A (p=0.015) presenting 10.93 times more chance of presenting chronic pain, Pain at 48 hours (p=0.009) with 2.79 more chance of progressing to DPPO and with 5.04 greater chance of presenting DPPO due to the use of antidepressants (p=0.041).Conclusion: Based on the results obtained, it is possible to associate risk factors such as anxiety and catastrophization to the development of DPPO, compared to the population studied. It is worth mentioning that the correct identification and treatment of AD and subacute are important factors to be evaluated during the anamnesis of patients who underwent cardiac surgery with sternotomy, in order to reduce the progression of the condition to DPPO, as pain in 48 hours after the procedure is also showed a risk factor. In addition, the fact of using antidepressants brings greater chances of developing DPPO, according to this study. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020-10-30 |
dc.date.accessioned.fl_str_mv |
2021-09-29T18:20:06Z |
dc.date.available.fl_str_mv |
2021-09-29T18:20:06Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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http://repositorio.ufsm.br/handle/1/22301 |
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http://repositorio.ufsm.br/handle/1/22301 |
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por |
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por |
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400000000001 |
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600 600 600 |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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Programa de Pós-Graduação em Ciências da Saúde |
dc.publisher.initials.fl_str_mv |
UFSM |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Ciências da Saúde |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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