Genel Cerrahi Hastalarında Ameliyat Sonrası Ağrı Şiddeti ve Kurtarıcı Analjezik Uygulamasının Değerlendirilmesi: Prospektif Bir Kohort Çalışması

Yıl 2026, Cilt: 9 Sayı: 1, 223 - 231, 17.03.2026

Esma Gökçe , Derya Gezer , Hamide Şişman , Ahmet Gökhan Sarıtaş , Sevban Arslan

https://izlik.org/JA59TR48TC

Öz

Amaç: Bu çalışma, elektif genel cerrahi hastalarında postoperatif ağrı şiddetini ve zamana bağlı kurtarıcı analjezik uygulama paternini incelemek ve bununla ilişkili faktörleri belirlemek amacıyla yapılmıştır. Gereç ve Yöntemler: Bu prospektif tanımlayıcı kohort çalışması, Şubat 2022- Ocak 2023 tarihleri arasında üçüncü basamak bir üniversite hastanesinde değerlendirilen toplam 369 elektif genel cerrahi hastasını kapsamaktadır. Ağrı şiddeti (Görsel Analog Skalası- VAS) ve kurtarıcı (ek) analjezik uygulamaları postoperatif 0-2, 3-4, 5-8, 9-12 ve 13-24. saatlerde kaydedildi. Ağrı yoğunluğu ve opioid kullanımı ile ilişkili demografik ve klinik faktörler analiz edildi. Sonuç: Ortalama ağrı şiddeti 0-2. saatlerden 13-24. saatlere doğru anlamlı şekilde azaldı (2.39 ± 1.75'e karşın 1.69 ± 2.17, p<0.001). Ağrı şiddeti, 0-2. saatlerde kadınlarda; 3-4. saatlerde ise yaşlı yetişkinlerde (≥65 yaş) ve kronik hastalığı olanlarda daha düşüktü. Erkek hastaların erken postoperatif dönemde opioid alma olasılığı daha yüksekti ve 3-4. saatlerde opioid kullanımı kronik hastalığı olmayan hastalarda daha fazlaydı. Tartışma: Postoperatif ilk 24 saat boyunca ağrı şiddeti azalırken, kurtarıcı analjezik uygulaması zamanla arttı. Kurtarıcı analjezik paternleri yaş, cinsiyet ve kronik hastalık durumundan etkilendi. Düşük ağrı skorları ağrı yönetiminin genel olarak yeterli olduğunu gösterse de artan kurtarıcı analjezik ihtiyacı rutin uygulamanın geliştirilmeye açık olduğunu işaret etmektedir. Bu bulgular, cerrahi hemşireliği uygulamasında yapılandırılmış ağrı değerlendirmesini, yeniden değerlendirmesini ve bireyselleştirilmiş, multimodal postoperatif ağrı yönetimini desteklemektedir.

Anahtar Kelimeler

Postoperatif ağrı , Kurtarıcı analjezi , Genel cerrahi , Cerrahi hemşireliği , Ağrı yönetimi , Analjezikler

Etik Beyan

Çalışma için Çukurova Üniversitesi Tıp Fakültesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan onay (Tarih/No: 04.02.2022/119) ve araştırmanın yürütüldüğü Çukurova Üniversitesi Hastanesi’nden kurum izni alınmıştır. Çalışma, Helsinki Bildirgesi (2008) etik ilkelerine uygun olarak yürütülmüştür. Veri toplama öncesinde tüm katılımcılar çalışmanın amacı ve yöntemi hakkında bilgilendirilmiş olup, her birinden yazılı bilgilendirilmiş onam alınmıştır.

Evaluation of Postoperative Pain Severity and Rescue Analgesic Administration in General Surgery Patients: A Prospective Cohort Study

https://izlik.org/JA59TR48TC

Öz

Aim: This study was conducted to examine postoperative pain severity and the time-dependent pattern of rescue analgesic administration, and to identify factors associated with this pattern in elective general surgery patients. Materials and Methods: This prospective descriptive cohort study included a total of 369 elective general surgery patients evaluated between February 2022 and January 2023 in a tertiary university hospital. Pain severity (Visual Analogue Scale) and rescue (additional) analgesic administration were recorded at postoperative 0-2, 3-4, 5-8, 9-12, and 13-24 hours. Demographic and clinical factors associated with pain intensity and opioid use were analyzed. Results: Mean pain severity significantly decreased from 0-2 hours to 13-24 hours (2.39 ± 1.75 vs. 1.69 ± 2.17, p<0.001). Pain was lower among women at 0-2 hours and among older adults (≥65 years) and those with chronic disease at 3-4 hours. Male patients were more likely to receive opioids across the early postoperative period, and opioid use at 3-4 hours was higher in patients without chronic disease. Conclusions: During the first 24 postoperative hours, pain severity decreased while rescue analgesic administration increased over time. Rescue analgesic patterns were influenced by age, sex, and chronic disease status. Although low pain scores suggest generally adequate pain management, the increasing need for rescue analgesia indicates that routine practice is open to improvement. These findings support structured pain assessment, reassessment and individualized, multimodal postoperative pain management in surgical nursing practice.

Anahtar Kelimeler

Postoperative pain , Rescue analgesia , General surgery , Surgical nursing , Pain management , Analgesics

Etik Beyan

Approval for the study was obtained from the Çukurova University Faculty of Medicine Non-Interventional Clinical Research Ethics Committee (Date/No: 04.02.2022/119), followed by institutional permission from Çukurova University Hospital, where the research was conducted. The study was carried out in accordance with the ethical principles of the Declaration of Helsinki (2008). Prior to data collection, all participants were informed about the study's purpose and procedures, and written informed consent was obtained from each individual.

Kaynakça

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