Sasseron Ana Beatriz, Figueiredo Luciana Castilho de, Trova Kerolin, Cardoso Andréa Luciana, Lima Núbia Maria Freire Vieira, Olmos Sarita Colasanto, Petrucci Orlando
Faculdade de Ciências Médicas, UNICAMP, Brasil.
Rev Bras Cir Cardiovasc. 2009 Oct-Dec;24(4):490-6. doi: 10.1590/s0102-76382009000500010.
The post operative pain after open heart surgeries had been often reported. Meager reports about respiratory function and pain correlation had been reported. The aim of this article is to assess the pain intensity and location during hospital admittance and its effect on pulmonary function in patients underwent elective cardiac surgery.
Pulmonary function (lung volumes, respiratory pressures and peak expiratory flow) was assessed at the preoperative and post-operative time (1, 3 and 5 days) by ventilometer, manovacuometer and peak flow meter measurements. The assessment of pain intensity was carried out with a visual analogue scale for pain.
The majority of pain site was on sternotomy incision (50% of patients) and the intensity was higher at the first postoperative day (8.32 by visual scale measurement). All pulmonary variables decreased on post-operative time when compared to baseline values. All respiratory variables remained lower than to pre-operative time at fifth postoperative time (P > 0.05), with exception for respiratory rate. The pain and maximal inspiratory pressure showed a negative correlation at the first postoperative day (P = 0.019).
Postoperative pain decreased lung function in patients precluding deep inspirations, in special, at the first post-operative day.
心脏直视手术后的术后疼痛常有报道。关于呼吸功能与疼痛相关性的报道较少。本文旨在评估择期心脏手术患者入院期间的疼痛强度和部位及其对肺功能的影响。
术前及术后(第1、3和5天)通过肺量计、压力计和峰值流量计测量评估肺功能(肺容积、呼吸压力和呼气峰值流量)。采用视觉模拟疼痛量表评估疼痛强度。
大多数疼痛部位在胸骨切开术切口处(50%的患者),术后第1天疼痛强度较高(视觉量表测量为8.32)。与基线值相比,术后所有肺变量均下降。术后第5天时,除呼吸频率外,所有呼吸变量均低于术前水平(P>0.05)。术后第1天疼痛与最大吸气压力呈负相关(P=0.019)。
术后疼痛会降低患者的肺功能,尤其是在术后第1天,导致患者无法进行深呼吸。