SCIENTIFIC UPDATE ON POST-OPERATIVE PAIN MANAGEMENT IN ORTHOPEDIC SURGERY

Bianca Gabriella De Oliveira; Melissa Alves Aires Marques; Ábila Dutra Oliveira; Cícero Azevedo De Moraes Filho; Paloma Pinheiro De Aquino Peixoto; Fabricio Negreiros Holtz; Rafael Costa Nerys; Laís Cristina Pereira Da Silva; Marcella Rodrigues Costa Simoes

doi:10.37547/TAJMSPR/Volume05Issue11-02

Authors

Bianca Gabriella De Oliveira
Medical Student at The University Salvador - UNIFACS, Salvador, BA, Brazil
Melissa Alves Aires Marques
Medical Student at The University Iguaçu - UNIG, Itaperuna, RJ, Brazil
Ábila Dutra Oliveira
Resident Doctor Ortopedia E Traumatologia Do Hospital Santa Casa De Misericórdia De Vitória, ES, Brazil
Cícero Azevedo De Moraes Filho
Medical Student at the UNINASSAU, Recife, PE, Brazil
Paloma Pinheiro De Aquino Peixoto
Medical Student at the UNINASSAU, Recife, PE, Brazil
Fabricio Negreiros Holtz
Doctor Orthopedist And Traumatologist No Hospital Universitário De Nova Iguaçú(UNIG), Rio De Janeiro, RJ, Brazil
Rafael Costa Nerys
Doctor Orthopedist and Traumatologis No Hospital Estadual De Urgências De Goiás - Dr Valdemiro Cruz (HUGO), Goiânia, GO; Shoulder and Elbow No Hospital das Clínicas Da UFG, Goiânia, GO, Brazil
Laís Cristina Pereira Da Silva
Medical Student at The University Salvador - UNIFACS, Salvador, BA, Brazil
Marcella Rodrigues Costa Simoes
Doctor Orthopedist and Traumatologist No Hospital da Baleia, Belo Horizontes, MG; Hand and Microsurgery Surgeon No Hospital Maria Amélia Lins (FHEMIG), Belo Horizonte, MG, Brazil

DOI:

https://doi.org/10.37547/TAJMSPR/Volume05Issue11-02

Keywords:

Pain management Postoperative pain Postoperative pain in orthopedic surgeries

Abstract

Postoperative pain results from the nociceptive stimulus caused by the surgical aggression, coming from direct or indirect mechanisms. Its intensity and duration depends on several factors, mainly the type of surgical approach, surgical access and anatomy. Orthopaedic surgeries are considered one of the most painful, due to the intense nociceptive stimulation of the musculoskeletal tissue.The prevalence of post-operative pain is described in 73% of patients who experience moderate to severe pain on the first day after surgery. A lower prevalence is observed in developed countries, due to pain protocols, the presence of acute pain services and advanced general anesthesia techniques. Numerous protocols have been tested, and opioids are often the drugs of choice, but the events are considered the biggest drawback. Pain control can be achieved through the use of certain medications, the use of physical means and interventions related to cognitive behavior, such as educational techniques and relaxation. Even though it is difficult to treat pain, analgesic methods are essential to reduce the incidence of persistent pain, avoiding and alleviating future chronic pain conditions that are difficult to treat.

References

Alves, A.N., Costa, C.M.C., Siqueira, J.T.T., Teixeira, M,J. (2009). Dor: princípios e prática. Porto Alegre(RS): Artmed.

Bassanezi, B.S.B.,Oliveira Filho, A.G.(2006). Analgesia pós-operatória. Rev.Col. Bras. Cir. 33(2): 116-22.

Barbosa, M. H., Araújo, N. F. D., Silva, J. A. J. D., Corrêa, T. B., Moreira, T. M., & Andrade, É. V. (2014). Avaliação da intensidade da dor e analgesia em pacientes no período pós-operatório de cirurgias ortopédicas. Escola Anna Nery, 18, 143-147.

Brill, S., Ginosar, Y., Davidson, E.M. (2006). Perioperative management of chronic pain patients with opioid dependency. Curr Opin Anaesthesiol. 19(3):325-31.

Chunduri, A., Aggarwal, A.K. (2022). Multimodal Pain Management in Orthopedic Surgery. J Clin Med. 28;11(21):6386.

D’Amato, T., Martorelli, F., Fenocchio, G., Simili, V., Kon, E., Di Matteo, B., Scardino, M. (2019). Tapentadol vs oxycodone/naloxone in the management of pain after total hip arthroplasty in the fast track setting: an observational study. J Exp Orthop. 29;6(1):36.

Fishman, S,M. (2011). Strategies for selecting treatment and mitigating risk in patients with chronic pain. J Clin Psychiatry. 72(1):e02.

Fontes, K.B., Jaques, A.E. (2007). O papel da enfermagem frente ao monitoramento da dor como 5o sinal vital. Cienc. cuid. saude. 6(supl.2): 481-7.

Galvan, C., Paczek, R.S., de Brum, B.N., do Espírito Santo, D.M.N., Tanaka , A.K.S.da R., & Brito, D.T. (2020). A efetividade do tratamento da dor no pós operatório de cirurgias ortopédicas. Revista Eletrônica Acervo Saúde, 12(10), e4875.

Gasbjerg, K.S., Hägi-Pedersen, D., Lunn, T.H., Laursen, C.C., Holmqvist, M., Vinstrup, L.Ø., Ammitzboell, M., Jakobsen, K., Jensen, M.S., Pallesen, M.J., Bagger, J., Lindholm, P., Pedersen, N.A., Schrøder, H.M., Lindberg-Larsen, M., Nørskov, A.K., Thybo, K.H., Brorson, S., Overgaard, S., Jakobsen, J.C., Mathiesen, O. (2022). Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial. BMJ. 4;376:e067325.

González, R., García, R. (2018). Eficacia analgésica de la combinación Morfina/Dexketoprofeno versus Morfina/Paracetamol em pacientes sometidos a cirugía de miembros inferiores. Boletín Médico de Postgrado. 34(1): 7-12.

Lavand’homme, P.M., Kehlet, H., Rawal, N., Joshi, G.P. (2022). PROSPECT Working Group of the European Society of Regional Anaesthesia and Pain Therapy (ESRA). Pain management after total knee arthroplasty: PROcedure SPEcific Postoperative Pain ManagemenT recommendations. Eur J Anaesthesiol. 1;39(9):743-757.

Liggieri, A. C., Tsai, A. W. W., Machado, E. S., Moraes, F. B. D., Liu, I. A. W., Forni, J. E. N., ... & Cohen, M. (2019). Tratado de dor musculoesquelética.

Ndebea, A.S., van den Heuvel, S.A.S., Temu, R., Kaino, M.M., van Boekel, R.L.M., Steegers, M.A.H. (2020). Prevalence and Risk Factors for Acute Postoperative Pain After Elective Orthopedic and General Surgery at a Tertiary Referral Hospital in Tanzania. J Pain Res. 19;13:3005-3011.

Pimenta, C.A.M., Santos, E.M.M., Chaves, L.D., Martins, L.M., Gutierrez, B.A.O. (2001). Controle da dor no pós- operatório. Rev. Esc. Enferm. USP.35(2): 180-3.

Pitchon, D.N., Dayan, A.C., Schwenk, E.S., Baratta, J.L., Viscusi, E.R. (2018).Updates on Multimodal Analgesia for Orthopedic Surgery. Anesthesiol Clin.36(3):361-373.

Porto, C.C. (2004). Exame Clínico: bases para a prática médica. 5a ed. Rio de Janeiro(RJ): Guanabara Koogan.

Silva, T.R., Machetto, A., Pedrinelli, A., Santili, C. (2010). Consenso Brasileiro sobre Dor Perioperatória em Ortopedia e Traumatologia Desportiva. Revista Brasileira de Ortopedia, 45(3):2-15.

Silva, Y. B. D., & Pimenta, C. A. D. M. (2003). Análise dos registros de enfermagem sobre dor e analgesia em doentes hospitalizados. Revista da Escola de Enfermagem da USP, 37, 109-118.

Smeltzer, S.C., & Bare, B.G. (2005). Brunner & Suddarth, Tratado de enfermagem médico-cirúrgica. In Brunner & Suddarth, Tratado de enfermagem médico-cirúrgica(pp. 1133-1133). 246.