Comportamento da dor e da função pulmonar em pacientes submetidos à cirurgia cardíaca via esternotomia Pain and pulmonary function in patients submitted to heart surgery via sternotomy

Abstract

OBJETIVO: Avaliar o comportamento da função pulmonar e da dor em pacientes adultos submetidos à cirurgia cardíaca por esternotomia. Além de verificar possíveis correlações e comparações dessas variáveis com as características do procedimento cirúrgico e o tempo de internação hospitalar. MÉTODOS: Foi realizado estudo de coorte composto de 70 indivíduos, nos quais foi avaliada a função pulmonar préoperatória por espirometria e inspirometria de incentivo. Os pacientes foram acompanhados no pós-operatório, por meio de protocolo com informações da cirurgia, função pulmonar e um protocolo de avaliação álgica (escala análoga visual e desenho do corpo humano). RESULTADOS: Os valores de função pulmonar do período pós-operatório apresentaram diminuição significativa em relação ao pré-operatório (POBJECTIVE: To investigate the pulmonary function and pain in adult patients undergoing heart surgery via sternotomy and to verify possible correlations of these variables with the characteristics of the surgical procedure and hospital stay. METHODS: A cross-sectional study was carried out of 70 individuals undergoing heart surgery. The lung function was assessed before and after surgery by spirometry and incentive spirometry. Details of the surgical procedure were studied and patients were followed up postoperatively using a visual analogue scale and design of the human body to evaluate pain. RESULTS: The pulmonary function was significantly impaired in the postoperative compared to preoperative period (P <0.01). The pain was centered in the region of the sternotomy and persisted until at least the 5th postoperative day. There was a correlation between pain and the parameters of pulmonary function (forced expiratory volume in 1 second - percentage: r = -0.271, P <0.047; peak expiratory flow: r = 0.357, P <0.008; and maximum inspiratory volume: r = -0.293, P <0.032). There was no significant correlation between pain and other variables. CONCLUSION: There was significant impairment of lung function which had not recovered completely on the 5th postoperative day. Pain was a complaint that persisted throughout the study period. The parameters of pulmonary function showed a significant relationship with pain. There was no correlation between pain and the characteristics of individuals, the surgical procedure or the length of hospital stay.

Keywords

• Complicações pós-operatórias
• Testes de função respiratória
• Dor pós-operatória
• Medição da dor
• Postoperative complications
• Respiratory function tests
• Pain, postoperative
• Pain measurement