Ağrı Yönetimi
Özet
Ağrı yönetimi, hastaların konforunu sağlayarak ve iyileşme sürecini hızlandırarak erken taburculuk amacıyla gerçekleştirilir. Ameliyat sonrası ağrı yönetiminde ilaç ve ilaç dışı tedavi yöntemleri birlikte kullanılmaktadır. İlaç tedavisi arasında opioid, non-opioid, adjuvan ve diğer ilaçlar, ilaç dışı tedavi yöntemleri arasında ise fiziksel, davranışsal-bilişsel yöntemler ile alternatif tedavi yöntemleri yer almaktadır. Bu yöntemlerin kombinasyonu, hastaların ağrısını etkin bir şekilde yönetmeye yardımcı olur ve iyileşme sürecini destekler. Bu süreçte, ağrı yönetimi multidisipliner bir ekip yaklaşımını gerektirir ve hemşirelerin rolü oldukça kritiktir. Bu bağlamda hemşirelerin, cerrahi hastasının ağrısını değerlendirmesi, ağrı yönetiminde aktif rol almaları ve uygun tedavi girişimlerini planlamaları önemlidir.
Pain management is carried out to ensure the comfort of patients and accelerate the healing process for early discharge. Drug and non-drug treatment methods are used together in postoperative pain management. While drug treatment includes opioids, non-opioid, adjuvant, and other drugs, non-drug treatment methods include physical, behavioral-cognitive methods, and alternative treatment methods. The combination of these methods helps effectively manage patients' pain and supports the healing process. In this process, pain management requires a multidisciplinary team approach, and the role of nurses is very critical. Nurses need to evaluate patients' pain, take an active role in pain management, and plan appropriate treatment interventions.
Referanslar
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Pak DJ, Yong RJ, Kaye AD, et al. Chronification of pain: Mechanisms, current understanding, and clinical implications. Current Pain Headache Reports; 2018;22(2): 9. doi:10.1007/s11916-018-0666-8
Russo MM, Sundaramurthi T. An overview of cancer pain: Epidemiology and Pathophysiology. Seminars in Oncology Nursing; 2019;35(3): 223-228. doi: 10.1016/j.soncn.2019.04.002
Meints SM, Edwards RR. Evaluating psychosocial contributions to chronic pain outcomes. Progress in Neuropsychopharmacology & Biological Psychiatry; 2018; 87(Pt B):168-182. doi: 10.1016/j.pnpbp.2018.01.017
Smith TJ, Hillner BE. The Cost of Pain. JAMA Network Open; 2019;2(4): e191532. https://doi.org/10.1001/jamanetworkopen.2019.1532
Doleman B, Williams JP. Patient controlled analgesia: effective and cost-effective management of acute pain within the Emergency Department? Anaesthesia; 2017;72(8): 935-939. doi:10.1111/anae.13893
Fraser S. Chronic pain in family practice: research and insights. Canadian Family Physician; 2023;69(3): 153. doi:10.46747/cfp.6903153
Kizilhan JI. Trauma and pain in family-orientated societies. International Journal of Environmental Research and Public Health; 2017;15(1): 44. doi:10.3390/ijerph15010044.
Danilov A, Danilov A, Barulin A, et al. Interdisciplinary approach to chronic pain management. Postgraduet Medicine; 2020;132(sup3): 5-9. doi:10.1080/00325481.2020.1757305
Sneddon LU. Comparative physiology of nociception and pain. Physiology; 2018;33(1): 63-73. doi:10.1152/physiol.00022.2017
Burnstock G. Purinergic mechanosensory transduction and visceral pain. Molecular Pain; 2009;5: 69. doi:10.1186/1744-8069-5-69
Fenton BW, Shih E, Zolton J. The neurobiology of pain perception in normal and persistent pain. Pain Management; 2015;5(4): 297-317. doi:10.2217/pmt.15.27
Khan A, Khan S, Kim YS. Insight into Pain Modulation: Nociceptors Sensitization and Therapeutic Targets. Current Drug Targets; 2019;20(7): 775-788. doi:10.2174/1389450120666190131114244
Baron R, Binder A, Wasner G. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurology; 2010;9(8): 807-19. doi:10.1016/S1474-4422(10)70143-5
Michaelides A, Zis P. Depression, anxiety and acute pain: links and management challenges. Postgraduate Medicine; 2019;131(7): 438-444. doi:10.1080/00325481.2019.1663705
Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet; 2021;397(10289): 2082-2097. doi:10.1016/S0140-6736(21)00393-7
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Referanslar
Ersek M, Polomano RC. Pain. Assessment and management of clinical problems. In: Lewis S, Dirksen SR, Heitkemper MM, Bucher L, Camera I. (eds.) Medical-Surgical Nursing. 8th ed. Chapter 10, International Edition, Mosby; 2010. p. 127-135.
Pak DJ, Yong RJ, Kaye AD, et al. Chronification of pain: Mechanisms, current understanding, and clinical implications. Current Pain Headache Reports; 2018;22(2): 9. doi:10.1007/s11916-018-0666-8
Russo MM, Sundaramurthi T. An overview of cancer pain: Epidemiology and Pathophysiology. Seminars in Oncology Nursing; 2019;35(3): 223-228. doi: 10.1016/j.soncn.2019.04.002
Meints SM, Edwards RR. Evaluating psychosocial contributions to chronic pain outcomes. Progress in Neuropsychopharmacology & Biological Psychiatry; 2018; 87(Pt B):168-182. doi: 10.1016/j.pnpbp.2018.01.017
Smith TJ, Hillner BE. The Cost of Pain. JAMA Network Open; 2019;2(4): e191532. https://doi.org/10.1001/jamanetworkopen.2019.1532
Doleman B, Williams JP. Patient controlled analgesia: effective and cost-effective management of acute pain within the Emergency Department? Anaesthesia; 2017;72(8): 935-939. doi:10.1111/anae.13893
Fraser S. Chronic pain in family practice: research and insights. Canadian Family Physician; 2023;69(3): 153. doi:10.46747/cfp.6903153
Kizilhan JI. Trauma and pain in family-orientated societies. International Journal of Environmental Research and Public Health; 2017;15(1): 44. doi:10.3390/ijerph15010044.
Danilov A, Danilov A, Barulin A, et al. Interdisciplinary approach to chronic pain management. Postgraduet Medicine; 2020;132(sup3): 5-9. doi:10.1080/00325481.2020.1757305
Sneddon LU. Comparative physiology of nociception and pain. Physiology; 2018;33(1): 63-73. doi:10.1152/physiol.00022.2017
Burnstock G. Purinergic mechanosensory transduction and visceral pain. Molecular Pain; 2009;5: 69. doi:10.1186/1744-8069-5-69
Fenton BW, Shih E, Zolton J. The neurobiology of pain perception in normal and persistent pain. Pain Management; 2015;5(4): 297-317. doi:10.2217/pmt.15.27
Khan A, Khan S, Kim YS. Insight into Pain Modulation: Nociceptors Sensitization and Therapeutic Targets. Current Drug Targets; 2019;20(7): 775-788. doi:10.2174/1389450120666190131114244
Baron R, Binder A, Wasner G. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurology; 2010;9(8): 807-19. doi:10.1016/S1474-4422(10)70143-5
Michaelides A, Zis P. Depression, anxiety and acute pain: links and management challenges. Postgraduate Medicine; 2019;131(7): 438-444. doi:10.1080/00325481.2019.1663705
Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet; 2021;397(10289): 2082-2097. doi:10.1016/S0140-6736(21)00393-7
Treede RD, Rief W, Barke A, et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain; 2019;160(1):19-27. doi: 10.1097/j.pain.0000000000001384
Scher C, Petti E, Meador L, et al. Multidimensional pain assessment tools for ambulatory and inpatient nursing practice. Pain Management Nursing; 2020;21(5): 416-422. doi: 10.1016/j.pmn.2020.03.007
Breivik H, Borchgrevink PC, Allen SM, et al. Assessment of pain. British Journal of Anaesthesia; 2008;101(1): 17-24. doi:10.1093/bja/aen103
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