Post Operative Pain: the Cost of Pharmacological Therapy

Authors

  • Silvia Regina Secoli Professora doutora do Departamento de Enfermagem Médico-Cirúrgica da Escola de Enfermagem da Universidade de São Paulo
  • Kátia Grillo Padilha Professora associada do Departamento de Enfermagem Médico-Cirúrgica da Escola de Enfermagem da Universidade de São Paulo.
  • Júlio Litvoc Professor doutor do Departamento de Medicina Preventiva da Faculdade de Medicina da Universidade de São Paulo
  • Aparecida de Cassia Giani Peniche Professora doutora livre-docente do Departamento de Enfermagem Médico-Cirúrgica da Escola de Enfermagem da Universidade de São Paulo.

Keywords:

postoperative pain, costs, analgesics.

Abstract

- ln spite of the importance of analgesics used for postoperative pain control, there are not enough studies to evaluate their costs. Thus the present study  estimates  the  direct  cost s of analgesic    therapy    used    in  the postoperative period (PO) in 166 patients who have undergone hemorrhoidectomy in a  priva te hosp ita l. The categories of costs utilized we re: medications, disposable material, maintenance of intravenous access and labour performed by the nursing team. The cost of the analgesic therapy was R$10 .6 49, 20 being that 6 7% was spent in the administration of medicines of the regular protocol. The average cost of therapy per patient in immediate PO was R$ 31, 80 . The category of cost - administration of medications was pointed   out  in  PO, representing 48 .7% (immediate PO) and 48 .1 % (mediate PO) of the total cost of therapy. The knowledge of these va riab le costs introduces economic rationality among  health professiona ls,  not with the intention of substituting the practice of medicine but rather to integrate them.

References

Jurf JB, Nirschl A L. Acute pos ­ to pe rat ive pain manag e me n t : a comprehensive review and update. Crit Care Nurs O 1993; 16(1 ): 8-25.

Bonica JJ. The management of pain. 2 nd ed. Ph il ade lph ia : Lea & Febiger; 19 90 . Postoperative pain; 461-80 .

Ready LB, Edwards WT. Tratamento da dor agu da. Rio de J ane iro: Revinter ; 19 9 7 .

McCaffery M, Pasero C. Pain: clinicai manual. St Lou is: Mosby; 1 99 9 .

D'Amours RH, Ferrante FM . Postoperative pain management. J Orthop Sports Phis Ther 1996; 24(4) : 227 -34.

Cousins MJ. Acute and postoperat ive pain. ln: Wall PD, Melzack R . Texbook of pa i n . 3 rd ed . Londo n : Churchill Living stone; 1 99 4. P 357-86.

Kehlet H, Dahl J B. Postoperative pain. World J Surg 1 99 3; 1 7 (2) : 21 5-9 .

Weissman C. The metabolic response to stress: an overview and u pd at e. Anesthesiology 1990; 73(2) : 308-27 .

Secoli SR. Farmacoeconomia da terapia analgésica utilizada na dor pós-operat ória

[Tese] . São Paulo (SP): Escola de Enfermagem da USP; 200 2.

Hoffer J L. A nestesia. ln: Meeker MH, Rothock JC. A le xand er: cuidados de Enfermagem ao paciente cirúr gico. 1 Oª ed. Rio de J aneiro: Guanabara Koogan; 1 997 . P. 1 3 4-68.

Gabrielli F, Chiarelli M, Guttadauro A, Poggi L. The problem of pain after day-surgery haemorrh oidecto my. Ambul Surg 1998; 6: 29- 34.

Revista Farmacêutica K@ iros. Magnet Propaganda, Publicidade . São Paulo (SP) 2002; 164.

Guia Farmacêutico Brasíndice. São Paulo; 200 2.

Acute pain management in ad ults: operative procedure s. Üuick reference guide for cli n icians . Medsurg Nurs 1994; 3(2) : 99-10 7.

Acute pain management: operative or medical and traumas. Fed Regist 1992; 57(1) : 1 28-31 .

Choiniere M, Rittenhouse BE, Perreault S, Chartrand D, Rousseau P, Smith B et a i. Efficacy and costs of patient-controlled analgesia versus regulary administered intramuscular opioid thera py. Anesthesiology 1 998; 89 (6) : 1 377 -88.

Chaves LD. Controle da dor pós­ opera tória: comparação entre métodos analgésicos. [Dissertação]. São Paulo (SP): Escola de Enfermagem da USP; 2001 .

Munro AJ, Long GT, Sleigh J W. Nu rse-adm inistrated subcuta neous morphine is a satisf actory alterna tive to intravenous patient-controlled analgesia morphine after cardiac surgery. Anesth Analg 1998; 87(1) : 11-5

O'Halloran P, Brown R . Patient­ controlled analgesia compared with nurse-controlled infusion analgesia after heart surg ery. lntensive Crit Care Nurs 1997; 1 3(3) : 1 26-9 .

Chan VW, Chung F, McOuestion M, Gomez M. lmpact of patient­ controlled analgesia on required nursing time and duration of postoperative recovery. Reg Anesth 1 99 5; 20( 6) : 506-14.

Viitanen H, Annila P. Analgesic efficacy of tramado! 2 mg kg (-1) for paediatric day-case ade noidecto my. Br J Anaesth 2001; 86( 4) :57 2-5.

Ama ta AO, Samaroo LN, Monplaisir SN . Pain control after major surgery. East Afr Med J 1 999; 76(5) : 269-71 .

Kettelmann K. What ' s so bad about meperidine? Nursing 2000; 30(10):20.

Wacker MS, Moniz CJ. Meperidine : second-line agent with first­ line prescribing prad ices. Med Health R 1 2001; 84(1 O): 10-4.

Published

2006-07-01

How to Cite

Secoli, S. R., Padilha, K. G., Litvoc, J., & Peniche, A. de C. G. (2006). Post Operative Pain: the Cost of Pharmacological Therapy. Revista SOBECC, 11(2), 39–44. Retrieved from https://revista.sobecc.org.br/sobecc/article/view/328

Issue

Section

ORIGINAL ARTICLES