Elaboração de um protocolo assistencial para dor de pacientes adultos cirúrgicos

Abstract

OBJECTIVE: to identify and analyze the best scientific evidence and theoretical support for the development of a protocol assistance for pain management of surgical adult patients. METHODOLOGY: this is an exploratory study conducted in databases obtained through the descriptors in MeSH / Decs: Acute pain; chronic pain; General surgery; Analgesics; Clinical protocols; Practice guideline; Pain measurement; Pain; Post-Surgery; Post-Operative. The search was performed in PubMed, LILACS and COCHRANE data, using the PICO method, comprising articles written in English or Portuguese, from 2001 and classified according to the classification system LoE of the Oxford Centre for Evidence Based Medicine and grade of recommendation and level of evidence approach in treatment, prevention, etiology and diagnosis, the Grading of Recommendations Assessment, Development and Evaluation - GRADE. All copyrights are preserved. RESULTS: among the 424 articles found, 29 were selected. We identified evidence for the classification of pain intensity according to the type of surgery, the instruments for their assessment and the main pharmacologic agents for its management. The results showed that most of the articles are from Brazil and the United States, with the largest production in 2013 (8 articles), 2009 (5 items) and 2010 (4 articles). The best evidence found were 16 randomized clinical trials and systematic reviews of six randomized clinical trials. The measurement scale is the most widely used pain Visual Analog Scale. Should be classified according to their intensity and their management should be appropriate according to the prescribed analgesic potency. CONCLUSION: the studies identified numerous weaknesses, with no adequate pharmacological planning to surgical patients. The creation of this protocol provided a safe journey and a scientific basis for quality pain management and come to meet the guidelines established by the American Agency for Research and Quality in Public Health, and the American Pain Society.