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Pain management in the recovery room of the anesthesiology department
FRÜHAUFOVÁ, Tereza
The diploma thesis is focused on the issue of patients experiencing postoperative pain in a Post Anaesthesia Care Unit (PACU). The thesis is aimed at three basic goals. The first one is focused on the analysis of the pain a patient experiences in a PACU. The second goal is the in-depth comparison of the pain the patients experience after various surgeries and the third goal is to get the feedback on the nurses' approach to the pain assessment. The theoretical part of this thesis is focused on the detailed explanation and the division of pain, treatment of pain and the function and the equipment of a PACU. The research part of this thesis was carried out in the form of quantitative research. A form with 22 questions, which was targeted on nurses working at the PACU, was used for the data acquisition. The questions were aimed at obtaining detailed data related to the evaluation of postoperative pain, but also at obtaining the information regarding staffing in particular hospitals. 183 nurses working in 79 hospitals filled out the form. There was also monitoring of pain carried out with 83 patients in the PACU in the Military University Hospital Prague. The patients experienced various types of surgeries. The results could help to find suitable strategies of evaluating and postoperative pain treatment in the PACU. During the research, it became obvious that patients who underwent neurosurgical operations of the spine experience the most intense pain. On the contrary, patients who underwent urological surgeries experience the least intense pain According to nurses'opinion the most important factors in evaluating patient's pain are the verbal expression of the patients and the change of physiological functions. Neither the lenght of practice nor the education has statistically a significant influence on the final evaluation of patient's pain. The experienced nurses with long-term practice predominate in the PACU. Based on the information given by nurses, it is safe to assume that the current treatment of postoperative pain is sufficient. It's rather rare for a patient to have strong pain after running out of options in analgetic treatment. It's worth noting that there are significant differences in the staffing of the PACU across hospitals.
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Physiological significance of pain
Zámostná, Kateřina ; Vaculín, Šimon (advisor) ; Telenský, Petr (referee)
Pain is defined as a physiological process associated with negative emotional experience which warns our body about impending damage. Apart from neuropathic pain, which by definition has no purpose, pain in effect provides a defensive function. However, this role is already being fulfilled by a different mechanism - the defensive reflex, which is evolutionarily older. Therefore we can ask, whether pain is only an emotional experience attached to this reflex, or if it has its own functions. To determine the physiological purpose of pain a rare syndrome of congenital analgesia, characterized by complete absence of pain, will be used. Based on a comparison of clinical cases of the syndrome with a population without pain disorders individual functions of pain will be described and connected to the individual components of pain - sensory- discriminatiory and affective-motivational. The sensory-discriminatory component provides a defensive, diagnostic and an informative function. The defensive function is analogous to the defensive reflex. The informative function transmits information about a physiological process, where pain plays a key role - labour. Diagnostic function applies in medicine and is based on verbal description of the defensive function. Functions of the SD component are involved at the time of...
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Treatment of postoperative pain - Acute Pain Service
Karbanová, Vladislava ; Raudenská, Jaroslava (advisor) ; Jirkovský, Daniel (referee)
The Bachelor thesis focuses on the treatment of postoperative pain through teams Acute Pain Service (APS). In the theoretical part the basic information about the history of treatment, creation, management, componets and types of pain. Further theoretical part contains the characteristics of postoperative pain, the factors that affect it and treatment options, and provides an overview of the work teams APS in the Czech Republic and abroad. The empirical part focuses on the evaluation of the treatment of postoperative pain in patients Sokolov Hospital, where on some selected departments provided Acute Pain Service by anesthetic team of doctors and nurses. The aim of this work is to determine whether patients who receive this service is provided to assess the treatment of postoperative pain differently than those who are not provided. It also focuses on which factors and to what extent they can influence their decisions. To obtain the data were two questionnaires,non-standard questionnaire, which includes questions on any of these possible factors and standardized questionnaire WHOQOL-BREFF mapping the quality of life.
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Treatment of postoperative pain - Acute Pain Service
Karbanová, Vladislava ; Raudenská, Jaroslava (advisor) ; Jirkovský, Daniel (referee)
The Bachelor thesis focuses on the treatment of postoperative pain through teams Acute Pain Service (APS). In the theoretical part the basic information about the history of treatment, creation, management, componets and types of pain. Further theoretical part contains the characteristics of postoperative pain, the factors that affect it and treatment options, and provides an overview of the work teams APS in the Czech Republic and abroad. The empirical part focuses on the evaluation of the treatment of postoperative pain in patients Sokolov Hospital, where on some selected departments provided Acute Pain Service by anesthetic team of doctors and nurses. The aim of this work is to determine whether patients who receive this service is provided to assess the treatment of postoperative pain differently than those who are not provided. It also focuses on which factors and to what extent they can influence their decisions. To obtain the data were two questionnaires,non-standard questionnaire, which includes questions on any of these possible factors and standardized questionnaire WHOQOL-BREFF mapping the quality of life.
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Physiological significance of pain
Zámostná, Kateřina ; Vaculín, Šimon (advisor) ; Telenský, Petr (referee)
Pain is defined as a physiological process associated with negative emotional experience which warns our body about impending damage. Apart from neuropathic pain, which by definition has no purpose, pain in effect provides a defensive function. However, this role is already being fulfilled by a different mechanism - the defensive reflex, which is evolutionarily older. Therefore we can ask, whether pain is only an emotional experience attached to this reflex, or if it has its own functions. To determine the physiological purpose of pain a rare syndrome of congenital analgesia, characterized by complete absence of pain, will be used. Based on a comparison of clinical cases of the syndrome with a population without pain disorders individual functions of pain will be described and connected to the individual components of pain - sensory- discriminatiory and affective-motivational. The sensory-discriminatory component provides a defensive, diagnostic and an informative function. The defensive function is analogous to the defensive reflex. The informative function transmits information about a physiological process, where pain plays a key role - labour. Diagnostic function applies in medicine and is based on verbal description of the defensive function. Functions of the SD component are involved at the time of...
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The influence on postoperative analgesia by preemptive analgesia
Fricová, Jitka ; Stříteský, Martin (advisor) ; Štípek, Stanislav (referee) ; Kršiak, Miloslav (referee)
The aim of our study was to assess the changes of free radicals and other biochemical parameters after nociceptive stimulation in different experimental animal models. In patiens we detected whether preemptive analgesia had a positive effect on acute postoperative pain. Objective evaluation of pain intensity is a long-term problem because the objectification of using electrophysiological and imaging methods is currently difficult and expensive, and therefore in laboratories in the Czech Republic and many other places are used the evaluation by means biochemical methods. We implemented large experimental studies using mechanical, inflammatory and visceral nociception and we found out in particular that nitroxid and hydroxyl free radicals and singlet oxygen increased significantly after nociceptive stimulation. This increase can be suppressed by antioxidants. At the same time, we showed that some parameters of metabolism lipids, carbohydrates and proteins have also been changed. In particular, we measured the free hydroxyl radicals and singlet oxygen by EPR method in the tail of living and anesthetized rats. This method is absolutely a priority and has never been used before. Earlier experimental results were partially clinically verified using different types of acute and chronic pain in humans...
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Treatment of a pain from the perspective of nurse.
RŮŽIČKOVÁ NEUŽILOVÁ, Michaela
The theoretical section of a bachelor thesis deals with pain treatment, specifically of urgent post operational pain management treatment from the nurse's point of view. It is divided into several sections. First section is focused at pain in general, briefly characterizes the pain itself as well as its formation and division. This part also contains brief description of pain score and mostly used methods pain measurement. Then follows the part, where the urgent post operational pain as well as its specifics and cure possibilities are described. A post operational analgesia appearing by geriatric patients and kids is marginally mentioned here. In the conclusion of theoretical section there is mentioned the issue of urgent post operational treatment quality management. Thesis aim The main purpose of the bachelor thesis is to chart an evaluation of the level post-operative pain by general nurse in the post-operative unit. There are ways and technics, which are in general used on one side, on the other side opinion including practical experience. The second target is general information how to treat pain and to find shortage in management of quality treatment of postoperative pain. The third target is about to map the general nurse's practical skills in the care of patients with epidural catheter. Research methods A qualitative research was chosen for the empirical section of this bachelor thesis. A form of a half structured interview was used for data mining. The interviews with respondents were recorded in written way into in advance prepared form, consequently the qualitative data were analysed and organized according to their importance into categorization group with the coding technic pencil & paper. Results The research resulted, that nurses use VAS technic to chart the urgent post operational pain, which is also standardized pain record of particular medical institution. This technic is absolutely suitable for interviewed nurses, no other technics of pain score are used in daily routine. The nurses report clarity and intelligibility of the record of progression and pain treatment to be the main advantages in scoring pain according to VAS, which simplifies the communication with the other nursing team members participating on pain treatment of particular patient. Next result: Nurses working on post-operative units are not active enough to find symptoms of acute post-operative pain. Nurses wait for patients themselves to verbalize the pain. Nurses give a main cause of post operational pain postoperative wound, they don't accept other reasons. The next problem was discovered in organization of management of post operational acute pain. The main reason is bad accessibility or inaccessibility of attended physician. Also bad multiprofesional communication is guilty. Cooperation reaches on dead lock on bad communication, on confused records from preoperational and post operational period. Nurses have plenty of experience of treatment of urgent pain. Nobody from nurses has special education in algesiology. Care of patient with epidural catheter taken is provided in accordance with standard approach. Is an epidural analgesiology contributing for patients? Nurses answer positive. The main contribution is better cooperation in line patient staff and more effective care process. Conclusion The bachelor thesis is concerned on problematic and specify of care of patients with acute post-operative pain. Acute post-operative pain is good managed symptom, it is impossible to pass it. It could be negatively influenced postoperative recovering, it could be a reason of prolonged hospitalization, increasing costs of treatment. Untreated postoperative pain could lead to chronical problems with health in general.
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The role of the paramedic in the treatment of pain in the prehospital emergency care
ŠKOLKOVÁ, Aneta
The Bachelor thesis deals with a very current and spread topic in the sphere of the pre-hospital urgent care, it concerns the issue of pain and the role of the paramedic at its treatment in the pre-hospital urgent care. Pain is one of the most frequent indications initiating the medical ambulance service intervention. It is an affiliated and really essential stressor. The task for the paramedic is to help the patient suffering from pain and to use all ways of treatment which are possible to be applied in the sphere of the pre-hospital care. Therefore it is very important for the paramedics to be well informed on the issue of analgesia and to have good theoretical knowledge and to be able to apply it in practice. The theoretical part deals with the complex issue which is related to pain and with the role of the paramedic. At the beginning of the work there are defined basic concepts concerning the wide issue of pain, i.e. its types and categories form the localization point of view. Further, there is described the basic examination and getting information from the patient which form the integral part of information and data for consequent diagnosing and its possible therapies in the pre-hospital care. Therefore there is also a detailed elaboration of evaluating scales including the children´s ones. In order to get a sight into the issue of pain treatment there is integrated the subchapter concerning the invasive and non-invasive methods in the work. Next, the attention of the work is mostly focused on defining concepts of the pre-hospital urgent care and on the competences of the paramedic which form an integral part of the knowledge of this profession. It is related to possibilities of non-pharmacology and pharmacology treatment in the pre-hospital urgent care, which the specialist can use. The practical part was focused on recording of knowledge and procedures of paramedics in the process of pain treatment in the pre-hospital urgent care. There was carried out the whole republic inquiry using the quantitative method of anonymous questionnaire form. It was designed for the medical care workers working as paramedics. All regions in the Czech Republic were contacted; however, only eleven joined the research. Upon agreement with the managers of non-medical workers the questionnaires were delivered to paramedics. There were sent out 210 questionnaires while their return was 71.43% (150). All questionnaires were included in the consequent resultant inquiry. Responding paramedics were informed on the character of the research and assured that the anonymity of their person and the provided information will be preserved. The questionnaire involved 17 questions in total and the first five questions were statistical ones. The questions were focused on knowledge of analgesia and on procedure used by paramedics in the fieldwork. Questions 2, 4, 4a, 4b, 5, 8, 8a, 10, 10a, 11 were selected in order to get information whether the responding paramedics have knowledge on the issue of analgesia an in order to get base for answering the research question. The obtained information was consequently evaluated. Each question was answered individually and then transferred into diagrams (sometimes only into charts), which show their absolute and (mostly) relative frequency of obtained answers. The stated research question was (on the basis of the above mentioned 10 questions) evaluated by means of chi quadrate test. The obtained level of significance refused the stated ideal statement and confirmed results of the research which says that the knowledge of the paramedics is insufficient. The goal of the work was to record possibilities of pain treatment in the pre-hospital urgent care by the paramedic and it was fulfilled. Statistically evaluated questionnaire inquiry and answer to the research question show that further education of paramedics as well as their accepting the complex view of the issue is absolutely necessary.
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The role of nurses in the care of patients with acute pain in intensive care departments.
LINHARTOVÁ, Lucie
Diploma thesis entitled focuses on acute pain in general, as well as on post-operation pain, which is one of the types of acute pain. The first part of the thesis deals with acute pain as such and its characteristics. The second part deals with intensive care units (ICU). The third part contains description of post-surgery pain, treatment thereof, and the nurse?s role in taking care of clients suffering post-surgery pain. Three goals have been outlined. Goal 1: Identification of the techniques that nurses use at ICUs to sooth clients? pain. Goal 2: Map the monitoring the pain of clients hospitalized at ICUs. Goal 3: Find out whether the techniques for reducing pain of clients hospitalized at ICUs are effective. A quality-oriented research was applied for evaluation of the results, using a method of non-standardized interview with nurses and clients.The results can be used as a comparative overview of the most common pain-reducing techniques and proof of their effectiveness for clients.
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