PAIN MANAGEMENT

Patient's Experience of Pain Following Cardio-Thoracic Surgery

Abstract

The pain is now a major problem for patients in intensive care. It was recently declared as the fifth vital sign to be documented in the patient record adequate treatment of pain reduces pulmonary and postoperative cardiac complications. Pain after cardiac surgery is recognized and can reduce the postoperative mobilization and recovery lung. Strategies analgesics after cardiac surgery are limited. Epidural analgesia is not recommended given the risk of epidural hematoma. Use of the PCA does not seem than treatment administered by nurses in intensive care. Yet in ICU treatment of pain is often regarded as a priority low importance and finds neglected. This inadequate treatment of pain can also be associated with tracheal intubation and sedation preventing verbal communication of the patient. But another reason could be the absence or non-formalized Directive. Thus, the experts recommended the establishment of programs to improve the quality assessment and pain treatment in intensive care. The objectives of this research are to examine the quality efficiency improvement program the quality of the treatment of postoperative pain after cardiac surgery during and after stay in intensive care.

Patient's Experience of Pain Following Cardio-Thoracic Surgery

Introduction

Surgeries are the main source of acute pain (International Association for the Study of Pain, 2010c). However, although this type of pain is predictable and despite many efforts to raise awareness of the scientific community and professional associations, relief remains inadequate and there are still levels of moderate to severe pain in most patients (Brennan, Carr , & Cousins??, 2007; Sommer, et al, 2008). Postoperative pain unfortunately creates negative consequences for physiological, psychological and socio-economic course (Brennan et al., 2007).

Cardiac surgery is no exception to this reality. It goes without saying that these surgeries affect a large number of people, considering the importance of cardiovascular diseases represent the health problem causing the most mortality, disability and socioeconomic costs with cancer (Statistics Canada, 2007). Studies on post-heart surgery pain levels reported moderate to severe pain for up to six days after surgery (Gelinas, 2007). Some also complain that these results are unfortunately very similar to those of there almost 20 years despite advances in knowledge and awareness campaigns (Gelinas, 2007). In addition, postoperative pain associated with these surgeries become chronic in 17% to 56% according to studies (Lahtinen et al., 2006).

Pharmacotherapy as a Major Modality

Pharmacotherapy remains the main modality for pain relief after cardiac surgery. However, painkillers are reported to be administered in low doses in this population, despite the presence of moderate to severe pain. Individual and contextual barriers seem to be the cause of this phenomenon. For example, Watt-Watson et al. (2004) found in their study with clients who have undergone coronary artery bypass graft (CABG), on average 33% of the prescribed dose was administered and 80% of patients expected to experience moderate pain to severe. Yorke et al. (2004) found that nearly half of patients do not relate to the nursing staff they hurt. Finally, another study including patients with various surgeries ...