Analysis of medical records with opioid analgesic pharmacotherapy in the hospital setting
DOI:
https://doi.org/10.55892/jrg.v7i14.1228Keywords:
Pain, Analgesia, Surgery, Hospitalization, Drug CombinationAbstract
Pain is a common experience that affects people's lives in various ways and is extensively present in hospitals. Opioids are frequently used for the treatment of severe persistent pain, especially nociceptive pain, which is associated with tissue damage, such as postoperative pain and severe trauma. Although the use of opioids has proven effective in relieving intense pain, prolonged use can lead to health issues such as respiratory depression and reduced gastric mobility. However, the most concerning effects of opioids are tolerance, dependence, and hyperalgesia. Therefore, the prescription of these medications should be monitored and adapted to minimize potential risks and optimize treatment.The aim of the research is to identify and understand the therapeutic profile of medical records regarding the use of opioid analgesics in a hospital located in the western region of Paraná, Brazil. The methodology employed is an exploratory study with both qualitative and quantitative approaches, characterized by descriptive nature through medical records analysis. During the research, 198 medical records were examined, with 100 containing records of opioid use. It was observed that the most frequently prescribed opioids were tramadol, fentanyl, and morphine. Another relevant finding was the prevalence of 61% of female patients aged 29-39 years. Additionally, it was noted that the primary association between opioids was related to the administration of fentanyl and tramadol, although not concurrently. These results underscore the need for strategies aimed at more conscientious prescribing, considering non-opioid alternatives whenever possible. The continuous vigilance of healthcare professionals is emphasized to ensure treatment efficacy and minimize potential risks associated with opioid use.
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References
ARMSTRONG, Scott A; HERR, Michael J. Physiology, Nociception. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 1, 2023.
CALCATERRA, Susan L.; YAMASHITA, Traci E.; MIN, Sung-Joon; KENISTON, Angela; FRANK, Joseph W.; BINSWANGER, Ingrid A. Opioid Prescribing at Hospital Discharge Contributes to Chronic Opioid Use. Journal of General Internal Medicine, v. 31, p.478–485, Nov. 2016. https://doi.org/10.1007/s11606-015-3539-4
CARVALHO, Thiara S.; CARDOSO, Andressa R., FREITAS-DE-ANDRADE, Kaio V.; SANTOS-JUNIOR, Manoelito C. Potential drug-drug interactions in neonatal intensive care unit of a public hospital in Bahia, Brazil. Revista Brasileira Farmácia Hospitalar e Serviços de Saúde [Internet], [s.l.], jun. 2021. https://doi.org/10.30968/rbfhss.2021.122.0628
CASAGRANDE, Enzo Pizoni; SABEC PEREIRA, Dayane Kelly. Analysis of handbooks of patients affected with chronic residual pain after hip surgery with drug therapy. Research, Society and Development, [s.l.], v. 11, n. 13. 2022. https://doi.org/10.33448/rsd-v11i13.35232
COLUZZI, Flaminia; TAYLOR JR., Robert; PERGOLIZZI JR., Joseph V.; MATTIA, Consalvo; RAFFAF, Robert B. Orientação para boa prática clínica para opioides no tratamento da dor: os três ‘‘Ts’’ - titulação (teste), ajustes (individualização), transição (redução gradual). Revista Brasileira de Anestesiologia. v. 66, n. 3, p.310-317, 2016. http://dx.doi.org/10.1016/j.bjan.2016.02.008
COSTA, Matheus Ignácio Lopes da; CAMPOS, Isabela Oliveira; BELO, Matheus Herthel Souza; CUNHA, Pedro Henrique Ananias da; SILVA, Rodrigo Moraes Cançado da; AGUIAR, Guilherme de Araújo; SILVA, Márcio Heitor Stelmo da; PAULA, Antônio José da Fonseca de; PUJATTI, Priscilla Brunelli. Prevalência de dor e adequação da terapia analgésica em um hospital público referência. Revista Médica de Minas Gerais, v. 29, suppl. 8, p. 65-70, 2019.
COSTA, Aniceto Neto Elias; NAPOLI, Allan Eurípedes Rezende. Revisão bibliográfica da abordagem do tratamento da dor crônica não oncológica, com base na escada analgésica da organização mundial de saúde. Brazilian Journal of Health Review, [s.l.], v. 5, n. 4, p. 14365–14381, 2022. https://doi.org/10.34119/bjhrv5n4-198
COSGRAVE, David; SHANAHAN Enda; CONLON, Niamh. Opióides intratecais. Anaesthesia Tutorial of the week, v. 347, 2017.
DOS SANTOS, Alex Douglas Alves Pereira; SOUZA, Igor Gonçalves de; MALTA, Jessica Soares; COSTA, Josiane Moreira da; SILVA, Kênia Lara. Avaliação do acompanhamento farmacoterapêutico de idosos hospitalizados em uso de analgésicos opioides. Revista de Enfermagem do Centro-Oeste Mineiro, [s.l.], v. 10, 2020. p. 3665-3665. Out.2020. https://doi.org/10.19175/recom.v10i0.3665
DOWELL Deborah; RAGAN, Kathleen R.; JONES, Christopher M., BALDWIN, Grant. T.; CHOU, Roger. Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. Morbidity and Mortality Weekly Report Recommendations and Report. v.71, n. 3, p. 1–95, nov. 2022.
FRANCELLINO, Márcia Andréa Marques. Avaliação do Uso de Opioides em Serviço de Urgência e Emergência no Município de Foz do Iguaçu-PR. Foz do Iguaçu, 2022. 79 f. Dissertação de Mestrado. Programa de Pós-Graduação em Biociências, UNILA (Universidade Federal da Integração Latino-Americana)
GAN, Tong J. Poorly controlled postoperative pain: prevalence, consequences, and prevention. Journal of Pain Research. v. 25, n. 10, p. 2287-2298, set. 2017. https://doi.org/10.2147/JPR.S144066.
HERSH, Evan V.; MOORE, Patrick A.; GROSSER, Tilo; POLOMANO, Rosemary Carol; FARRAR, John T; SARAGHI, Mana; JUSKA, S.A. MITCHEL, Claire H. THEKEN, Katherine N. Nonsteroidal Anti-Inflammatory Drugs and Opioids in Postsurgical Dental Pain. Journal of Dental Research. v. 99, n. 7, p. 777-786. 2020. https://doi.org/10.1177/0022034520914254
KRAYCHETE, Durval Campos; GARCIA, João Batista Santos Garcia; SIQUEIRA, José Tadeu Tesseroli de. Recomendações para uso de opioides no Brasil: parte IV. Efeitos adversos de opioides. Revista Dor, v. 15, n. 3, p. 215-223, Jul-Set. 2014. https://doi.org/10.5935/1806-0013.20140047
LANGNAS, Erica; BISHARA, Andrew; CROCI, Rhiannon; RODRIGUEZ-MONGUIO, Rosa; WICK, Elizabeth C. CHEN, Catherine L.; GUAN, Zhnghui. Opioid prescribing practices at hospital discharge for surgical patients before and after the Centers for Disease Control and Prevention’s 2016 opioid prescribing guideline. BMC Anesthesiology, v. 22, n. 141, Mai, 2022. https://doi.org/10.1186/s12871-022-01678-6
LOWENSTEIN, Margaret; HOSSAIN, Erik; YANG, Wei; GRANDE, David; PERRONE, Jeanmarie; NEUMAN, Mark D.; ASHBURN, Michael; DELGADO, M. Kit. Impact of a State Opioid Prescribing Limit and Electronic Medical Record Alert on Opioid Prescriptions: a Difference-in-Differences Analysis. Journal of General Internal Medicine. [s.1.] v. 35, p. 662-671, Mar, 2020. https://doi.org/10.1007/s11606-019-05302-1.
MINKOWITZ, Harold; LEIMAN, David; LU, Lucy; REINES, Scott; RYAN, Michael; HARNETT, Mark; SINGLA, Neil. IV Tramadol – A New Treatment Option for Management of Post-Operative Pain in the US: An Open-Label, Single-Arm, Safety Trial Including Various Types of Surgery, Journal of Pain Research, [s.1.], p. 1155-1162, 2020. https://doi.org/10.2147/JPR.S251175.
NICHOLSON, Bruce. Responsible Prescribing of Opioids for the Management of Chronic Pain. Drugs. v. 63, n. 1, p. 17–32. 2003. https://doi.org/10.2165/00003495-200363010-00002
WEISZ, Russell D; FOKIN, Alexander A; LERNER, Vivian BSa; FLYNT, Amy; MACIAS-PEREZ, Ines; PAVLIV, Leo; CRAWFORD, Maggie; PUENTE, Ivan. Intravenous Ibuprofen Reduces Opioid Consumption During the Initial 48 Hours After Injury in Orthopedic Trauma Patients. Journal of Orthopaedic Trauma. v. 34, n. 7, p. 341-347, Jul. 2020. https://doi.org/10.1097/BOT.0000000000001733
RAMOS-RANGEL, Germán E.; FERRER-ZACCARO, Leopoldo E.; MOJICA-MANRIQUE; Viviana L.; GONZÁLEZ-LA ROTTA, Mariana. Manejo analgésico durante el postoperatorio de cesárea: estrategias farmacológicas, Revista Colombiana de Anestesiología, [s.l.], v. 45, n.4, p. 327-334. Out-dez. 2017. https://doi.org/10.1016/j.rca.2017.08.001
RIBEIRO, Sonia B. Felix; PINTO, João Carlos Pizani; RIBEIRO, João Batista; FELIX, Márcia M. Santos; BARROSO, Sabrina Martins; OLIVEIRA, Lucas Felix; FELIX, Andreza A; NASCIMENTO, Valdênia das Graças; RIBEIRO, Matheus F. Felix, SOUSA, Fátima A. Emm Faleiros. Dor nas Unidades de Internação de um Hospital Universitário. Revista Brasileira de Anestesiologia, v. 62, n. 5, Set-Out. 2012. https://doi.org/10.1590/S0034-70942012000500001
RITTER, James; FLOWER, Rod; HENDERSON, Graeme; LOKE, Yoon Kong; MacEWAN, David; RANG, Humphrey. Rang & dale: Farmacologia. 9. ed. Rio de Janeiro: Grupo Editorial Nacional S A. Editora Guanabara Koogan Ltda., 2022.
ROMANELLI, Robert J.; SHENOY, Rivfka; MARTINEZ, Meghan C.; MUDIGANTI, Satish; MARIANO, Louis T.; ZANOCCO, Kyle A.; WAGNER, Zachary; KIRKEGAARD, Allsion; WATKINS, Katherine E. Disparities in postoperative opioid prescribing by race and ethnicity: an electronic health records-based observational study from Northern California, 2015–2020. Archives of Public Health, v. 81, n. 83, Mai. 2023. https://doi.org/10.1186/s13690-023-01095-2
SALLUM, Ana Maria Calil; GARCIA, Dayse Maioli; SANCHES, Mariana. (2012). Dor aguda e crônica: revisão narrativa da literatura. Acta Paulista de Enfermagem, São Paulo, v. 25, n. 1, p. 150-154.
