Sezaryen sonrası ağrının karakteristik özelliği

Yıl 2021, Cilt: 4 Sayı: 1, 1 - 6, 21.01.2021

Tuğba Gürbüz Nefise Tanrıdan Okçu

https://doi.org/10.32322/jhsm.719225

Öz

Amaç: Çalışmada, elektif veya acil nedenlerden dolayı sezaryen yapılan hastalarda postoperatif ağrının karakteristik özelliklerini analiz etmek amaçlanmıştır.
Gereç ve Yöntemler: Bu çalışma, sezaryen yapılan 78 hastayı içeren gözlemsel ve tanımlayıcı bir kesitsel analizdir. Araştırma esnasında hastaların ilk 6 saatteki görsel ağrı skalası (VAS) skorları değerlendirilmiş ve ağrılarının karakteristik tanımlamaları sorgulanmıştır.
Bulgular: Postoperatif ilk 6 saatteki ortalama VAS skorları 5.56 ± 1.31'dir. Hastaların ağrı hissettiği vücut lokalizasyonu insizyon bölgesinde %7.7, umbilikus altında %14.1, tüm karın bölgesinde %23.1, insizyonun sağ tarafında %50, insizyonun sol tarafında %1.3, insizyonun her iki yanında %3,8 olarak saptanmıştır. Hastaların anestezi tipleri ve VAS skorları karşılaştırıldığında, ortalamalar arasındaki fark, istatistiksel olarak anlamlı bulunmamıştır (p> 0.05). Ağrının yeri ile sezaryen sayısı arasında istatistiksel olarak anlamlı bir fark tespit edilmemiştir (p> 0.05). Postoperatif mobilizasyon saatleri ile hastaların memnuniyet skorları arasında istatistiksel olarak anlamlı bir ilişki saptanmıştır (p <0.05).
Sonuç: Sezaryen sonrası ağrının azaltılması; annenin iyileşme süreci ve anne ile bebek arasındaki erken bağın gelişimi için oldukça önemlidir. Sezaryen sonrası ağrının en çok hissedilen yeri tespit edilir, değerlendirilir ve özellikleri belirlenirse; ağrıyı azaltmak veya ortadan kaldırmak için uygun müdahaleler planlanabilir.

Anahtar Kelimeler

Ağrı, Doğum, Sezaryen

Destekleyen Kurum

Yok

Charecteristics of postcesarean section pain

Öz

Aim: The aim of this study was to analyze the characteristics of postoperative pain in patients undergoing cesarean delivery for elective or urgent reasons.
Material and Methods: This study is an observational descriptive cross-sectional analysis involving 78 patients who underwent cesarean delivery. Visual Pain Scale (VAS) scores of 78 patients were evaluated in the first 6 hours and the patients were asked about the characteristic descriptions of the pain.
Results: Mean VAS scores in the first 6 hours postoperatively were 5.56 ± 1.31. Body localizations where the patients feel pain were 7.7% in the incision site, 14.1% under the umbilicus, 23.1% in the whole abdominal region, 50% on the right side of the incision, 1.3% on the left side of the incision and 3.8% on both sides of the incision. When the anesthesia types and VAS scores of the patients were compared, the differences between the averages were not statistically significant (p > 0.05). There was no statistically significant difference between the location of pain and the number of cesarean sections (p >0.05). There was a statistically significant relationship between the postoperative mobilization hours and the patients' satisfaction scores (p < 0.05).
Conclusion: Treatment of the post-cesarean pain is very important for the recovery process of the mother and the development of the early bond between the mother and the infant. If the post-cesarean delivery pain is identified, evaluated and its characteristics are determined, appropriate interventions can be made to reduce or eliminate the pain.

Anahtar Kelimeler

Cesarean, Delivery, Pain

Kaynakça

• 1. Yanıkkerem UE, Kitapçıoğlu G, Karadeniz G. Women's view of birth methods, experience and satisfaction. Fırat Sağlık Hizmetleri Dergisi. 2010;5(13):107-123.
• 2. Yanıkkerem UE, Göker A, Nicole Piro N. Women’s opinions about mode of delivery and satisfaction with hospital care after cesarean delivery. Selçuk Tıp Dergisi. 2013;29(2):75-81.
• 3. Çapık A, Sakar T, Yıldırım N, Karabacak K, Korkut M. Determining the satisfaction levels of the mothers according to their mode of birth. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi.2016;19(2):92-99.
• 4. Pınar G, Doğan N, Algıer L,Kaya N, Çakmak F. Factors that affecting mothers’ postnatal comfort.Dicle Tıp Dergisi .2015; 36(3), 184-190.
• 5. Brown AK, Christo PJ, Wu CL. Strategies for Postoperative Pain Management. Best Pract Res Clin Anaesthesiol. 2004;18(4):703-17.
• 6. Shea RA, Brooks JA, Dayhoff NE, Keck J. Pain Intensity and Postoperative Pulmonary Complications Among the Elderly After Abdominal Surgery. Heart & Lung: The Journal of Acute and Critical Care. 2002;31(6):440-9.
• 7. Wang H-L, Keck JF. Foot and Hand Massage as an Intervention for Postoperative Pain. Pain Management Nursing. 2004;5(2):59-65.
• 8. Huang SY, Sheu SJ, Tai CJ, Chiang CP, Chien LY. Decision-making process for choosing an elective cesarean delivery among primiparas in Taiwan. Matern Child Health J. 2013; 17: 842–851.
• 9. Henriksen L, Grimsrud E, Schei B, Lukasse M. Factors related to a negative birth experience - A mixed methods study. Midwifery. 2017; 51:33-39.
• 10. Villar J, Valladares E, Wojdyla D, et al. Cesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. The Lancet. 2006;367(9525):1819-29.
• 11. Eyi EGY, Mollamahmutoglu L. An analysis of the high cesarean delivery rates in Turkey by Robson classification. J Matern Fetal Neonatal Med. 2019;1:1-11.
• 12. Güngör I, Kızılkaya Beji N. Development and psychometric testing of the scales for measuring maternal satisfaction in normal and cesarean birth. Midwifery 2012;28(3):348-5.
• 13. Saunders WB. Cesarean Delivery, High RiskPregnancy. 2 nd ed. Harcourt Publishers Limited. 1999;1:10-12.
• 14. Klopfenstein CE, Herrmann F, Mamie C, Van Gessel E, Forster A. Pain intensity and pain relief after surgery. Acta Anaesthesiologica Scandinavica. 2000;44(1):58-62.
• 15. D'Arcy YM. Pain management: Evidence-based tools and techniques for nursing professionals: marblehead, MA: Hcpro Incorporated; 2007;2:164.
• 16. Duncan GH, Bushnell MC, Lavigne GJ. Comparison of verbal and visual analogue scales for measuring the intensity and unpleasantness of experimental pain. Pain.1989;37(3):295-303.
• 17. Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain. 1986;27(1):117-26.
• 18. D'Arcy YM. Pain assessment in medical-legal aspects of pain and suffering. Lawyers & Judges Publishing Company. 2003.
• 19. Olofsson CI, Legeby MH, Nygards EB, Ostman KM. Diclofenac in The Treatment of Pain After Cesarean Delivery. An Opioid-Saving Strategy. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2000;88(2):143-6.
• 20. Valente SM. Hypnosis for Pain Management. Journal of Psychosocial Nursing and Mental Health Services. 2006;44(2):22-30.
• 21. Coll MA.,Jemel R M.,Mead D. Postoperative pain assesment tools in day surgery: literature review. J Adv Nurs. 2004;46:2.
• 22. Ngan Kee W, Khaw K, Wong E. Randomised double-blind comparison of morphine vs. a morphine–alfentanil combination for patient controlled analgesia. Anaesthesia. 1999; 54(7): 629-33.
• 23. Vijayan R, Delilkan A. First year’s experience with an acute pain service–University Hospital Kuala Lumpur. Med J Malaysia. 1994;49(4):385-400.
• 24. Taenzer P, Melzack R, Jeans ME. Influence of psychological factors on postoperative pain, mood and analgesic requirements. Pain. 1986;24(3):331-42.
• 25. Boyle P, Parbrook GD. The interrelation of personality and postoperative factors. Br J Anaesth. 1977; 49 (3): 259-264.
• 26. Chung F, Ritchie E, Su J. Postoperative pain in ambulatory surgery. Anesthesia & Analgesia. 1997;85(4):808-16.
• 27. Fecho K, Miller NR, Merritt SA, Klauber, DeMore N, Hultman CS, Blau WS. Acute and persistent postoperative pain after breast surgery. Pain Medicine. 2009;10(4):708-15.
• 28. Kessous R, Weintraub AY, Wiznitzer A, et al. Spinal versus general anesthesia in cesarean deliverys: the effects on postoperative pain perception. Archives of gynecology and obstetrics. 2012;286(1):75-79.
• 29. Gonano C, Leitgeb U, Sitzwohl C, Ihra G, Weinstabl C, Kettner SC. Spinal versus general anesthesia for orthopedic surgery: anesthesia drug and supply costs. Anesthesia & Analgesia. 2006;102(2):524-9.
• 30. SousaI L., Pitangui ACR, Gomes FA, Nakano AMS, Ferreira CHJ. Measurement and characteristics of post-cesarean delivery pain and the relationship to limitation of physical activities. Acta paul. enferm. 2009; 22: 6.
• 31. Astepe B.S. The Relationship Between Preoperative Anxiety Level and Postoperative Pain in Patients With Cesarean Delivery. Kocaeli Med J. 2018; 7; 3:64-69.
• 32. Niven C. How helpful is the presence of the husband at childbirth? Journal of Reproductive and Infant Psychology. 1985;3(2):45-53.
• 33. Granot M, Lowenstein L, Yarnitsky D, Tamir A, Zimmer EZ. Postcesarean delivery pain prediction by preoperative experimental pain assessment. Anesthesiology.2003;98(6):142-226.