Pain measurement as part of primary healthcare of adult patients with sickle cell disease

OBJECTIVE: The aim of this exploratory, cross-sectional study was to evaluate pain in sickle cell disease patients and aspects related to primary healthcare. METHODS: Data were obtained through home interviews. The assessment instruments (body diagram, Numerical Pain Scale, McGill Pain Questionnaire) collected information on the underlying disease and on pain. Data were analyzed using the Statistical Package for Social Sciences program for Windows. Associations between the subgroups of sickle cell disease patients (hemoglobin SS, hemoglobin SC, sickle β-thalassemia and others) and pain were analyzed using contingency tables and non-parametric tests of association (classic chi-square, Fisher's and Kruskal-Wallis) with a level of 5% (p-value < 0.05) being set for the rejection of the null hypothesis. RESULTS: Forty-seven over 18-year-old patients with sickle cell disease were evaluated. Most were black (78.7%) and female (59.6%) and the mean age was 30.1 years. The average number of bouts of pain annually was 7.02; pain was predominantly reported by individuals with sickle cell anemia (hemoglobin SS). The intensity of pain (Numeric Pain Scale) was 5.5 and the quantitative index (McGill) was 35.9. This study also shows that patients presented a high frequency of moderately painful crises in their own homes. CONCLUSION: According to these facts, it is essential that pain related to sickle cell disease is properly identified, quantified, characterized ...

Efeitos da adiçåo de epinefrina à bupivacaína isobárica em anestesia subaracnóidea / Effects of added epinephrine on spinal anesthesia with isobaric bupivacaine

The effects of epinephrine added to 0,5 por cent isobaric bupivacaine for spinal anesthesia were investigated in 96 patients ASA Physical Status I or II, aged 15-87 years old, undergoing surgeries below T12. Patients classified in Group A (n=48) received 15 mg of 0,5 por cent isobaric bupivacaine and patients classified in Group B (n=48) received 0,2 mg of epinephrine added to 15 mg of isobaric bupivacaine. The response to the pinprick stimulation did not show significant differences in times to achieve analgesia in L3-L4 and T12 and no differences were observed in terms of cephalic spread of the anesthesia and incidence of complications. Howerever, significant prolongtion of motor block observed in Group B patients who received epinephrine added to isobaric bupivacaine