RESUMO
BACKGROUND: Early and optimal treatment of postoperative pain based on a multimodal treatment concept is very important so that subsequent chronification can be avoided. OBJECTIVES: This study investigated the influence of progressive muscle relaxation on the sensation of pain and the need for analgesics after orthopedic interventions. MATERIALS AND METHODS: This nonrandomized pilot study tested 104 patients in the Clinic of Orthopedics at the Saarland University Medical Center in Homburg, Germany. The patients underwent total endoprosthesis (TEP) of the or the knee or spine surgery (laminectomy), and they had the option of choosing to use the technique of progressive muscle relaxation. All patients completed a questionnaire on the first, fourth, and ninth postoperative day. Data were collected on the maximum and minimum intensity of pain, duration of strong pain, length of hospital stay, and use of pain medication. These were compared by means of t tests for the group with progressive muscle relaxation and the group without progressive muscle relaxation. RESULTS: No significant difference was observed between the two groups regarding pain sensation analgesic dosage. There was a tendency for the length of hospital stay to be shorter in the group with progressive muscle relaxation. CONCLUSION: The positive effect of progressive muscle relaxation cannot be confirmed on the basis of the study data. Owing to the varying study design and implementation as well as the inclusion of heterogeneous patient groups, no conclusion can be drawn at present regarding the effectiveness of progressive muscle relaxation in common practice; therefore, further research is necessary.
Assuntos
Treinamento Autógeno , Dor Pós-Operatória , Analgésicos , Alemanha , Humanos , Dor Pós-Operatória/terapia , Projetos Piloto , Terapia de Relaxamento , Resultado do TratamentoRESUMO
Einleitung: Trotz immer besserer medizinischer und operativer Therapiemaßnahmen bleibt eine adäquate Schmerztherapie für viele gynäkologische Krankheitsbilder eine He-rausforderung. Neue patientenfokussierte Testsysteme können dabei zur Verlaufsbeurteilung und Therapieoptimierung beitragen. Ziel war es, die Pilot-Ergebnisse unserer, in Deutschland einmaligen, interdisziplinären, universitär geführten, integrativen Schmerzsprechstunde anhand neu-ester patientenfokussierter Testsysteme auszuwerten und zur weitergehenden interkollegialen Diskussion vorzustellen. Materialien und Methoden: Retrospektive, monozentrische Analyse der Behandlungsverläufe von Patientinnen einer neuen integrativen und interdisziplinären, gynäkologischen Schmerzsprechstunde mittels patientenfokussiertem Testsystem (PROMIS-29). Ergebnisse: Insgesamt konn-ten die Ergebnisse von 18 Patientinnen analysiert werden. Zur Nachuntersuchung zeigten sich signifikante Verbesserungen in allen Domänen des PROMIS-29. Schlussfolgerung: Die vorgestellte interdisziplinäre, integrative Schmerz-sprechstunde unter Zuhilfenahme patientenfokussierter Testsysteme kann relevante Schmerzdomänen erfassen und erfolgreich therapieren. Weitere Untersuchungen müssen diese neue Art der Verlaufsbeobachtung und gynäkologisch fokussierter Schmerzbehandlung nun mit längeren Nach-sorgeintervallen bestätigen.
Assuntos
Doenças dos Genitais Femininos/terapia , Medicina Integrativa , Clínicas de Dor , Manejo da Dor/métodos , Medidas de Resultados Relatados pelo Paciente , Feminino , Humanos , Projetos Piloto , Estudos RetrospectivosRESUMO
Dermatosurgery occupies an exceptional position among all surgical disciplines. Above all, this includes the fact that, with very few exceptions, the vast majority of surgical interventions can be performed under local or regional anesthesia, usually in smaller procedure rooms that are spatially separated from larger operating suites. Thus, peri- and postinterventional patient monitoring is the responsibility of the dermatosurgeon and his team. Though inherently smaller, this team still has to observe numerous perioperative requirements that - in larger surgical specialties - would be attended to by a host of various specialists working in concert. Said requirements include hygienic aspects, knowledge concerning pre- and intraoperative patient monitoring, managing surgical site infections, adequate postsurgical pain management, as well as detailed pharmacological knowledge with respect to common local anesthetics and the toxic and allergic reactions associated therewith. Not only does this require interdisciplinary collaboration and shared responsibility for the patient. It also necessitates the development and implementation of quality-oriented and evidence-based guidelines that, in the dermatosurgical setting, usually extend far beyond the scope of the specialty per se. The objective of the present CME article is the condensed presentation of interdisciplinary aspects relating to the most important perioperative issues.