Abstract
ABSTRACT BACKGROUND AND OBJECTIVES: The objective of this study was to correlate the level of anxiety presented in the preoperative period with the intensity of pain reported by elderly in the immediate postoperative period of transvesical prostatectomy. METHODS: Sixty-four elderly patients submitted to transvesical prostatectomy were studied, using the following instruments: the numeric pain scale and Hamilton anxiety rating scale in the preoperative; and the short-form McGill pain questionnaire (Portuguese version adapted) in the immediate postoperative period. The elderly divided into four groups, according to the level of anxiety presented in the preoperative period: absent, mild, moderate and intense. The Spearman correlation was established between preoperative anxiety levels and postoperative pain intensity. RESULTS: There was a significant positive correlation between the level of preoperative anxiety and pain intensity in the immediate postoperative period. The pain curves (sensitive and affective) presented a significant increase at moments 6, 18 and 24h in all groups. These curves were significantly higher in the elderly with moderate and intense anxiety than in those without anxiety and mild anxiety. The pain peak was recorded at 18h after surgery in all groups. CONCLUSION: In the elderly, the level of anxiety presented in the preoperative period was positively correlated with the pain response in the immediate postoperative of transvesical prostatectomy. The use of preoperative measures that reduce anxiety can improve analgesia in the immediate postoperative period of this surgery and, therefore, reduce the amount of analgesics used in this period. There was also a need for intervention with adequate analgesia at the postoperative pain peak which occurred 18h after surgery.
Highlights
The elderly population is submitted four times more to the number of surgeries than the non-elderly, and this number has been increasing progressively[1]
This study aimed to evaluate the pain in the immediate PO of the elderly undergoing transvesical prostatectomy (TVP), correlating their degree with the anxiety level found in the preoperative period
Exclusion criteria were: severe status, physical status ASA III, that is, in a state of clinical decompensation[21]; cognitive deficit, evaluated with the Mini Mental State Examination (MMSE)[22]; chronic pain[4], pain index above 3 on the numerical pain scale (NPS)[23], in usual use of drugs or assisted in an outpatient clinic of pain; depression or anxiety diagnosed by a physician, using an antidepressant or permanent anxiolytic drug, or attending a psychiatric outpatient clinic for anxiety or depression treatment; anesthesia different from that used in the research protocol
Summary
The elderly population is submitted four times more to the number of surgeries than the non-elderly, and this number has been increasing progressively[1]. This study aimed to evaluate the pain in the immediate PO of the elderly undergoing TVP, correlating their degree with the anxiety level found in the preoperative period. AND OBJECTIVES: The objective of this study was to correlate the level of anxiety presented in the preoperative period with the intensity of pain reported by elderly in the immediate postoperative period of transvesical prostatectomy. RESULTS: There was a significant positive correlation between the level of preoperative anxiety and pain intensity in the immediate postoperative period. The pain curves (sensitive and affective) presented a significant increase at moments 6, 18 and 24h in all groups These curves were significantly higher in the elderly with moderate and intense anxiety than in those without anxiety and mild anxiety. CONCLUSION: In the elderly, the level of anxiety presented in the preoperative period was positively correlated with the pain response in the immediate postoperative of transvesical prostatectomy.
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