AMELİYAT SONRASI AĞRI YÖNETİMİNE İLİŞKİN HEMŞİRELİK YAKLAŞIMLARI

Yıl 2024, Cilt: 4 Sayı: 11

Gamze Oğuz Erdem , Hande Yümnü

https://doi.org/10.54270/atljm.2024.61

Öz

Ameliyat sonrası, bireylerin %80 'inden fazlası orta ila şiddetli düzeyde akut ağrı yaşarlar. Kontrol edilemeyen postoperatif ağrı, iyileşmeyi sınırlandırır ve kısa ve uzun vadeli morbidite ile ilişkilidir. Cerrahi uzmanlar geleneksel olarak postoperatif ağrı yönetiminden sorumluyken, cerrahi hastalara bakım sağlayan tüm klinisyenler ortak farmakolojik ve girişimsel ağrı yönetimi stratejileri konusunda temel bir anlayışa sahiptir. Bu derlemede, akut ağrının sonuçlarını, ağrı değerlendirme yaklaşımlarını ve postoperatif ağrıyı yönetmek için yaygın olarak kullanılan tedavilere genel bir bakış ve hemşirelerin postoperatif ağrı yönetiminde rolü ve uygulamaları ele alınmıştır.

Anahtar Kelimeler

Ağrı, Postoperatif Ağrı, Ağrı Yönetimi, Hemşirelik

Nursing Approaches Toward Postoperative Pain Management

Öz

After surgery, more than 80% of people experience moderate to severe acute pain. Poorly controlled postoperative pain limits healing and is associated with detrimental short-term and long-term morbidity. While surgeons have traditionally been responsible for postoperative pain management, all clinicians caring for surgical patients have a basic understanding of common pharmacological and interventional pain management strategies. In this review, an overview of the outcomes of acute pain, pain assessment approaches and commonly used treatments to manage postoperative pain, and the role and practices of nurses in postoperative pain management are discussed.

Anahtar Kelimeler

pain, postoperative pain, pain management, nursing

Kaynakça

• Aslan Eti F, Arlı Karadağ Ş. Ağrı Değerlendirilmesi ve Klinik Karar Verme. İçinde: Fatma AE (ed). Sağlığın Değerlendirilmesi ve Klinik Karar Verme. Akademisyen Tıp Kitabevi Yayın Dağıtım ve Pazarlama A.Ş.; 2017:103-133.
• Pain Terms and Definitions. International Association for the Study of Pain (IASP). https://www.iasppain.org/resources/terminology/Erişim Tarihi: 29.12.2023.
• Özveren H, Faydalı S, Gülnar E, ve ark. Hemşirelerin ağrı değerlendirmesine ilişkin tutum ve uygulamaları. Journal Of Contemporary Medicine. 2018; 8(1): 60-66. doi: 10.16899/gopctd.388195.
• Uyar M, Korhan Akın E. Yoğun Bakım Hastalarında Müzik Terapinin Ağrı ve Anksiyete Üzerine Etkisi. Ağrı. 2011; 23(4): 139-146. doi: doi: 10.5505/agri.2011.94695
• Mahran GS, Leach MJ, Abbas MS, et all. Effect of Eye Masks on Pain and Sleep Quality in Patients Undergoing Cardiac Surgery: A Randomized Controlled Trial. American Association of Critical-Care Nurses. 2020; 40. doi:10.4037/ccn2020709.
• Adams SDM, Varaei S, Jalalinia F. Nurses’ Knowledge and Attitude towards Postoperative Pain Management in Ghana. Pain Research and Management. 2020; 7. doi:10.1155/2020/4893707.
• Madenski AD. Improving Nurses’ Pain Management in the Post Anesthesia Care Unit (PACU). Doctor of Nursing Practice (DNP) Projects. 36, 2014, [Erişim Tarihi: 28.12.2023]. ErişimAdresi:https://scholarworks.umass.edu/cgi/viewcontent.cgi?article=1034&context=nursing_dnp_capstone .
• Mazda Y, Jadin S, Khan JS, et all. Postoperative Pain Management. CJGIM. 2021; 16(1): 1-17.
• Small C, Laycock H. Acute postoperative pain management. BJS. 2020; 107, 70-80.
• Woolf CJ, Salter MV. Neuronal plasticity: increasing the gain in pain. Science. 2000; 288(5472):1765-1768.
• Fornasari D. Pain pharmacology: focus on opioids. Clin Cases Miner Bone Metab. 2014;11(3):165–168.
• Doody O, Bailey ME. Understanding pain physiology and its application to person with intellectual disability. Journal of Intellectual Disabilities. 2019; 23(1): 5-18.
• Mazhaqbeh M, AbuRuz ME. Pain Management: A systematic review. IOSR Journal of Nursing and Health Science (IOSR-JNHS). 2017; 6(1): 75-80.
• Pergolizzi Jr JV, van de Laar M, Langford R, et al., Tramadol/ paracetamol fixed-dose combination in the treatment of moderate to severe pain. J Pain Res. 2012; 5: 327-346.
• Dijkstra BM, Berben, SAA, Van Dongen, RT. Review on pharmacological pain management in trauma patients in (prehospital) emergency medicine in the Netherlands. Eur J Pain. 2014; 18(1): 3-19.
• Groninger H, Vijayan J. Pharmacologic management of pain at the end of life. Am Fam Physician. 2014; 90(1): 26-32.
• Prommer EE. Pharmacological Management of Cancer-Related Pain. Cancer Control: Journal Of The Moffitt Cancer Center. 2015; 22(4): 412-425.
• Park HJ, Moon DE, Pharmacologic management of chronic pain. The Korean Journal Of Pain. 2010; 23(2): 99-108.
• Guindon J, Walczak JS, Beaulieu P. Recent advances in the pharmacological management of pain. Drugs. 2007; 67(15): 2121-2133.
• Kroenke K, Krebs EE, Bair MJ. Pharmacotherapy of chronic pain: a synthesis of recommendations from systematic reviews. General Hospital Psychiatry. 2009; 31(3): 206-219.
• Sciulli MG, Capone ML, Tacconelli S, et al. The future of traditional nonsteroidal antiinflammatory drugs and cyclooxygenase-2 inhibitors in the treatment of inflammation and pain. Pharmacological Reports. 2005; 57: 66-85.
• Fine PG. Treatment Guidelines for the Pharmacological Management of Pain in Older Persons. Pain Medicine. 2012; 13: S57- S66.
• Abdulla, A, Bone M, Adams N, et al. Evidence-based clinical practice guidelines on management of pain in older people. Age and Ageing. 2013; 42(2): 151-153.
• Nersesyan H, Slavin KV. Current aproach to cancer pain management: Availability and implications of different treatment options. Therapeutics And Clinical Risk Management. 2007; 3(3): 381-400.
• Pujol LA, Monti DA. Managing cancer pain with nonpharmacologic and complementary therapies. J Am Osteopath Assoc. 2007; 107(7): 15-21.
• He HG, Jahja R, Lee TL, et al. Nurses’ use of non-pharmacological methods in children’s postoperative pain management: educational intervention study. J Adv Nurs. 2010; 66(11): 2398-409.
• Menefee LA, Monti DA. Nonpharmacologic and Complementary Approaches to Cancer Pain Management. The Journal of the American Osteopathic Association. 2005; 105(5):15-20.
• Boldt I, Eriks‐Hoogland I, Brinkhof MW, et al. Non-pharmacological interventions for chronic pain in people with spinal cord injury. Cochrane Database of Systematic Reviews. 2014; 11: CD009177. doi: 10.1002/14651858.CD009177.pub2.
• Salantera, S, Lauri S, Salmi TT, et al. Nurses’ knowledge about pharmacological and nonpharmacological pain management in children. J Pain Symptom Manage. 1999; 18(4): 289-99.
• Gelinas C, Arbour C, Michaud C, et al. Patients and ICU nurses’ perspectives of non-pharmacological interventions for pain management. Nursing in Critical Care. 2013; 18(6): 307-318.
• Polkki TK, Vehvilainen-Julkunen K, Pietila AM. Nonpharmacological methods in relieving children’s postoperative pain: a survey on hospital nurses in Finland. J Adv Nurs. 2001; 34(4): 483-92.
• Gorodzinsky AY, Bernacki JM, Davies WH, et al. Community Parents’ Use of Non-Pharmacological Techniques for Childhood Pain Management. Children’s Health Care. 2012; 41(1): 1-15.
• Menlah A, Garti I, Amoo SA, et al. Knowledge, Attitudes, and Practices of Postoperative Pain Management by Nurses in Selected District Hospitals in Ghana. SAGE Open Nursing. 2018; 4:1–11. doi:10.1177/2377960818790383.
• Akpolat R, Şişman H, Alptekin D, Gökçe E, Gezer D, Arslan S. Ameliyat sonrası ağrıya yaklaşımların değerlendirilmesi. Cukurova Medical Journal. 2021, 46(2):670-676. doi: 10.17826/cumj.898769.
• Eder SC, Solan EP, Todd K. Documentation of ED patient pain by nurses and physicians. The American Journal of Emergency Medicine. 2003; 21(4):253-257.doi: 10.1016/S0735-6757(03)00041-X.
• Çelik S, Baş BK, Korkmaz ZN, et al. Hemşirelerin Ağrı Yönetimi Hakkındaki Bilgi ve Davranışlarının Belirlenmesi. Bakırköy Tıp Dergisi. 2018; 14, 17-23. doi:10.5350/BTDMJB.20160905103604.
• Karadağ Arlı Ş. Cerrahi Bakımda Ağrı Yönetimine İlişkin Hemşirelik Girişimleri. MCBU-SBED. 2017; 4(3):1013-1020.