Pain Assessment and measurement of combined spinal - epidural post analgesia during childbirth labor: an experiemental focus / Mensuração e avaliação da dor pós analgesia raqui-peri combinada durante o trabalho de parto: um enfoque experimental

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

The aim of this study was to measure the pain intensity during labor with or without combined spinal-epidural analgesia utilizing psychophysical methods, whether they be category estimations (visual analogical scale VAS) , or magnitude estimations, to verify the stability, to validate the psychophysical scale of pain perception, and to characterize the pain descriptors during labor pain. The psychophysical methods utilized were magnitude estimations and cross-modal matching. A total of four experiments were performed: Experiment 1 Pain threshold determination task; Experiment 2 magnitude estimations and category estimations; Experiment 3 magnitude estimations and line lengths; and Experiment 4 psychophysical scale validation. The study was comprised of 68 parturients (42 received analgesia, and 26 without analgesia), admitted in the Obstetrics center of the Interior Hospital in the state of Sao Paulo, age ranging from 18 to 35, with a singleton fetus, physical state ASA I or II, and who were in labor.The diverse pain sensations were assessed every 60 minutes (after obstetric routine), until the the end of labor (parturients who did not receive analgesia) , or until the application of labor analgesia recommended by the medical team.The analgesia was applied by means of combined spinal epidural analgesia . Fifteen minutes after installing the catheter, a new pain assessment was carried out when the observation period was concluded. Labor with or without analgesia was the responsibility of the medical team, not undergoing influence from the researcher, and the participant could accept or decline. The results were that each participant presented personal timing in determining their threshold. The physiological and psychological aspects evidenced that pain is a unique and individual experience.For the comparison of pain intensity during childbirth labor in the groups with analgesia and the groups without analgesia (after measurement), utilizing the Mann-Whitney statistical test, a significant difference between the pain intensities for both groups (p<0,001) was found. The psychophysical scale for pain intensity before analgesia was validated with the exponent 0,63, after analgesia the exponent was 0,95, and without analgesia 0,91. Kendall`s correlation coefficient (W) was applied to the magnitude estimations and the line-lengths before, after and without analgesia , W=0,46, W=0,90, and W=0,66 resepctively, indicating correlation between the data. The parturients` most attributed pain descriptors during labor were: unbearable, despairing, and terrible.

ASSUNTO(S)

psicofísica mensuração da dor psychophysical analgesia analgesia pain measurement

ACESSO AO ARTIGO

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