Anesthesia and Clinical Research

  • Trigemme neuralgia: literature review

    Introduction: Neuralgia is a pain that stretches along the path of a nerve. As regions of the head and neck are more affected places and a trigeminal neuralgia is more common among facial neuralgias. Objective: To review the literature on the concept, diagnosis and treatment of trigeminal neuralgia. Methodology: An integrated review was carried out in the MEDLINE, LILACS and SCIELO Virtual Library databases, using the following documents: Neuragia and Trigêmeio. The results of the research were published in all cases, in Portuguese, Portuguese and Portuguese. Results and Discussion: The search resulted in 6,205 articles, these, 30 were separated by amount of subject matter, however, only Nine meeting the inclusion criteria. A trigeminal neuralgia belongs to the group of chronic pain conditions and is classified as primary and secondary. It has a predominance of females, between 50 and 70 years of age and almost always is unilateral. Pain is characterized as paroxysmal, acute, superficial, triggered by the estimation of trigger zones, most of the life born and the skin of the middle region of the face. The patient may present hyposthesia or paraesthesia of a certain area and paralysis of one or more masticatory muscles. The diagnosis is clinical, as well as complementary tests in cases of neuropathic pain. The initial treatment is done by non-invasive methods, with the use of carbamazepine medicines. It can be surgically tested, which is success in 70 and 85% of cases. Conclusion: The articles presented, of facial neuralgias, one that is a bit slower and more common. It has a variable and prolonged clinical course regarding the frequency and intensity of pain. The treatment can be medicated or surgical.

  • Total pain in patients with uterine cervix cancer in palliative care

    Introduction: Cervical cancer is the second most frequent neoplasm in the female population. Among its range of symptoms, pain is one of the most exceeded. Total pain is a set of physical, psychic, social, and spiritual problems that may be present at any time of illness. More precisely in cervical neoplasia in young patients, this type of pain may be present due to falling ill in the productive phase. Objective: to discuss the presence of total pain in patients with uterine cervix cancer in palliative care. Methodology: This is an integrative review of the literature. The LILACS and SciELO databases were used. The following descriptors were used: Cancer pain; Nursing care and cervical neoplasias. From this, 45 articles were found. Contextualizing the inclusion criteria, which were: available text, language in Portuguese and year of publication from 2011 to 2016, 18 articles emerged. With the reading, it was noticed that 10 of these met the objective of the research. Results and Discussion: It was verified that all articles bring the definition of pain according to the National Association for the Study of Pain, in which it is a sensitive and emotional experience, which may be associated with actual or potential tissue damage. 40% demonstrate that poor pain relief is a reality for many patients. Already 30% report that the tendency to focus only on the physical aspect of pain and to exclude the other components is a great obstacle to the management of pain in palliative care. Conclusion: Total pain in patients in palliative care is influenced by several factors, necessitating a multidimensional approach. It has been realized that it is not possible to control physical pain, nor any other symptom, without the simultaneous control of all other aspects that cause suffering to patients.

  • Multidisciplinary intervention in the relief of pain in chronic wounds: experience report

    Introduction: According to the International Association for the Study of Pain (IASP), pain is an unpleasant sensation or emotional experience associated with actual or potential tissue damage.1 Furthermore, pain involves psychological and social factors, so it is a multidimensional, complex, subjective and perceptive phenomenon. Pain in chronic wounds is a concern for both the patient and the health care team. This is a complex approach and requires a multidisciplinary approach. Objective: To describe the experience of a resident nurse within the multidisciplinary team in the care of patients with chronic wounds. Methodology: This is an experience report of a resident nurse during the care of patients with impaired skin integrity at the university hospital of Aracaju. The nurse worked with a multiprofessional team, consisting of psychologist, physiotherapist, speech therapist, nutritionist, pharmacist, social worker and dentist. Results and Discussion: Several approaches were used in the treatment, to mention: adequacy of technique and coverage in dressings, intensification of decubitus changes and movement in bedridden patients, besides the execution, adequacy and orientation of basic human needs. Interventions with the medical team consisted of a crucial and difficult point for the improvement of the pharmacological management of pain. In addition, daily humanization has become a key element in the best response to the treatment and its consequences. Thinking about the patient as a biopsychosocial and spiritual being, we use specialized psychological support, interventions that encompass social issues, involvement of religious beliefs when recognized as a comfort point in the suffering process, and music therapy during multidisciplinary care. Conclusion: The developed activities promoted better results in pain management and evidenced the importance of the performance of the multiprofessional team as a determinant for this improvement. In addition to exposing the best model of approach and humanization to the patient and family.

  • Presidency on elderly people with arterial hypertension and mellitus diabetes: literature review

    Introduction: Population aging is now a global event, determining greater growth of the elderly population in relation to the other age groups. The hearing loss due to aging is known as presbycusis, characterized by bilaterally decreased auditory acuity, generally for high frequency sounds, due to degenerative and physiological changes in the auditory system that have arisen with increasing age. Studies have shown that chronic diseases affecting the elderly may be related to hearing disorders. Among these diseases, the most frequent are diabetes mellitus and hypertension. Objective To describe the hearing loss of elderly patients with diabetes mellitus (DM) and systemic arterial hypertension (SAH) from a bibliographic survey. Methodology: This is a bibliographic review research carried out in the SciELO database. Inclusion criteria were: complete scientific papers published in the Portuguese language, published in the period from 2011 to 2015,that present in the title some of the descriptors: elderly, diabetes mellitus, systemic arterial hypertension. Results and Discussion: We found 27 articles, of which 7 were selected for the review, since the others did not present data relevant to the research, were duplicated and did not fit the other inclusion criteria. According to the research, drastic changes were observed when comparing the elderly living with DM and SAH with those without chronic diseases, also showing an adverse effect on the cochlea, resulting in the loss of hair cells that, through mechanotransition, detect the sounds. Conclusion: It can be observed that the elderly with DM and SAH presented higher hearing loss of high frequency neurosensory when compared to groups without these chronic diseases, suggesting a synergistic effect of the medications to treat the pathologies.

  • Pharmaceutical care in the palliative care of the oncological patient

    Introduction: The oncology has been developing rapidly and the pharmacist’s main challenge is to be up-to-date with new studies about the subject. Palliative care is involved in the protection and responsibility for the patient’s well-being. This area requires a multidisciplinary team that cares for patients suffering from serious diseases, even if there is a possibility of cure. The purpose of pharmaceutical care is to analyze prescriptions, check drug interactions, dosages and side effects. Objetive: To identify the importance of the pharmacist in the palliative care of cancer patients. Methodology: Review of published researches from 2010 to 2017 in the Google Scholar, Scielo and Bireme databases, using the descriptors pharmaceutical care and Palliative Care. Results and Discussion: The pharmacist can intervene in therapy to reduce symptoms, as often the medications may be responsible for some of these symptoms. It can also check if the therapy can be well tolerated if it is being uncomfortable for the patient to receive a particular drug or suggest to the doctor in charge to replace a drug of unpleasant taste, for example. Pharmaceutical care in palliative care is focused on informing the health team about the availability of medicines, regarding pharmacotechnical possibilities and legal aspects, as well as patients and their families, about the correct use and storage of medicines. Conclusion: The presence of the pharmacist in palliative care is extremely important both in the patient’s medical treatment and in ensuring the necessary comfort to the patient and the promotion of health in general.