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Becerra-Bolaños Á, Armas-Domínguez A, Valencia L, Jiménez-Marrero P, López-Ruiz S, Rodríguez-Pérez A. Pain Prevalence and Satisfaction with Pain Management in Inpatients: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:3191. [PMID: 38132081 PMCID: PMC10743299 DOI: 10.3390/healthcare11243191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Pain in hospitalized adults is underestimated and undervalued. The aim of this study was to evaluate pain prevalence and satisfaction with the hospital's pain management among patients attending a tertiary university hospital. Predictor factors of pain were also studied. METHODS A prospective, cross-sectional study was carried out through a structured questionnaire given on one day to all hospitalized patients in a university hospital. Clinical data, such as personal history and analgesic treatment, were collected from medical records. Other variables related to pain (including intensity rated by the visual analogue scale as well as location and patient satisfaction measured by the numerical rating scale) were also obtained. RESULTS Of the 274 surveyed patients, pain prevalence was 52.9%, with an average intensity of 5.3 ± 2.8 according to VAS. The overall satisfaction was 87.2%, and 72.6% had already been prescribed at least one analgesic. Patients receiving analgesics showed higher pain intensity (VAS 3.6 ± 3.4) than those without treatment (VAS 1.1 ± 2.1) (p < 0.001). However, patients with treatment showed more satisfaction (NRS 7.8 ± 2 vs. 5.3 ± 1.4, p < 0.001). CONCLUSIONS The prevalence of pain in hospitalized patients was high, despite the fact that patient satisfaction was also very high.
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Affiliation(s)
- Ángel Becerra-Bolaños
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain (A.R.-P.)
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
| | - Annette Armas-Domínguez
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
| | - Lucía Valencia
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain (A.R.-P.)
| | - Pedro Jiménez-Marrero
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain (A.R.-P.)
| | - Sergio López-Ruiz
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain (A.R.-P.)
| | - Aurelio Rodríguez-Pérez
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain (A.R.-P.)
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
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Becerra-Bolaños Á, Jiménez-Gil M, Federico M, Domínguez-Díaz Y, Valencia L, Rodríguez-Pérez A. Pain in High-Dose-Rate Brachytherapy for Cervical Cancer: A Retrospective Cohort Study. J Pers Med 2023; 13:1187. [PMID: 37623438 PMCID: PMC10456084 DOI: 10.3390/jpm13081187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
High-dose-rate brachytherapy (HDR) is part of the main treatment for locally advanced uterine cervical cancer. Our aim was to evaluate the incidence and intensity of pain and patients' satisfaction during HDR. Risk factors for suffering pain were also analyzed. A retrospective study was carried out by extracting data from patients who had received HDR treatment for five years. Postoperative analgesia had been administered using pre-established analgesic protocols for 48 h. Pain assessment was collected according to a protocol by the acute pain unit. Analgesic assessment was compared according to analgesic protocol administered, number of needles implanted, and type of anesthesia performed during the procedure. From 172 patients treated, data from 247 treatments were analyzed. Pain was considered moderate in 18.2% of the patients, and 43.3% of the patients required at least one analgesic rescue. Patients receiving major opioids reported worse pain control. No differences were found regarding the analgesic management according to the intraprocedural anesthesia used or the patients' characteristics. The number of inserted needles did not influence the postoperative analgesic assessment. Continuous intravenous infusion of tramadol and metamizole made peri-procedural pain during HDR mild in most cases. Many patients still suffered from moderate pain.
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Affiliation(s)
- Ángel Becerra-Bolaños
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain; (Y.D.-D.); (L.V.); (A.R.-P.)
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35010 Las Palmas de Gran Canaria, Spain
| | - Miriam Jiménez-Gil
- Department of Anesthesiology, Complejo Hospitalario Universitario Materno Infantil, 35016 Las Palmas de Gran Canaria, Spain;
| | - Mario Federico
- Radiation Oncology Department, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain;
| | - Yurena Domínguez-Díaz
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain; (Y.D.-D.); (L.V.); (A.R.-P.)
| | - Lucía Valencia
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain; (Y.D.-D.); (L.V.); (A.R.-P.)
| | - Aurelio Rodríguez-Pérez
- Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain; (Y.D.-D.); (L.V.); (A.R.-P.)
- Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, 35010 Las Palmas de Gran Canaria, Spain
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Abad-Motos A, Ripollés-Melchor J, Jericó C, Bisbe E, Basora M, Colomina MJ, Becerra-Bolaños Á, Bermúdez-López M, Massa-Gómez C, Albaladejo-Magdalena J, Solar-Herrera A, Pérez-Chrzanowska H, Yárnoz C, Fedriani-de-Matos JJ, Blanco-Del-Val B, Fabián-González D, Bellver J, Redondo-Enríquez JM, Serrat-Puyol J, Abad-Gurumeta A, Zorrilla-Vaca A, Aldecoa C, García-Erce JA. Identification of the haemoglobin level associated with a lower risk of complications after total hip and knee arthroplasty. Acta Anaesthesiol Scand 2023; 67:629-639. [PMID: 36795045 DOI: 10.1111/aas.14217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/16/2022] [Accepted: 01/24/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Preoperative anaemia is associated with poor outcomes in surgical patients, but the preoperative haemoglobin cut-off that determines lower morbidity in total knee arthroplasty (TKA) and total hip arthroplasty (THA) is not well established. METHODS Planned secondary analysis of data collected during a multicentre cohort study of patients undergoing THA and TKA in 131 Spanish hospitals during a single 2-month recruitment period. Anaemia was defined as haemoglobin <12 g dl-1 for females and < 13 g dl-1 for males. The primary outcome was the number of patients with 30-day in-hospital postoperative complications according to European Perioperative Clinical Outcome definitions and specific surgical TKA and THA complications. Secondary outcomes included the number of patients with 30-day moderate-to-severe complications, red blood cell transfusion, mortality, and length of hospital stay. Binary logistic regression models were constructed to assess association between preoperative Hb concentrations and postoperative complications, and variables significantly associated with the outcome were included in the multivariate model. The study sample was divided into 11 groups based on preoperative Hb values in an effort to identify the threshold at which increased postoperative complications occurred. RESULTS A total of 6099 patients were included in the analysis (3818 THA and 2281 TKA), of whom 8.8% were anaemic. Patients with preoperative anaemia were more likely to suffer overall complications (111/539, 20.6% vs. 563/5560, 10.1%, p < .001) and moderate-to-severe complications (67/539, 12.4% vs. 284/5560, 5.1%, p < .001). Multivariable analysis showed preoperative haemoglobin ≥14 g dl-1 was associated with fewer postoperative complications. CONCLUSION Preoperative haemoglobin ≥14 g dl-1 is associated with a lower risk of postoperative complications in patients undergoing primary TKA and THA.
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Affiliation(s)
- Ane Abad-Motos
- Department of Anaesthesiology, Hospital Universitario Infanta Leonor, Madrid, Spain
- Department of Anaesthesiology, Hospital Universitario Donostia, San Sebastián, Spain
- Spanish Perioperative Audit and Research Network (RedGERM), Zaragoza, Spain
| | - Javier Ripollés-Melchor
- Department of Anaesthesiology, Hospital Universitario Infanta Leonor, Madrid, Spain
- Spanish Perioperative Audit and Research Network (RedGERM), Zaragoza, Spain
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anesthesiology and Critical Care (SEDAR), Spanish Society of Anesthesiology and Critical Care (SEDAR), Madrid, Spain
| | - Carlos Jericó
- Department of Internal Medicine, Complex Hospitalari Moisès Broggi, Barcelona, Spain
| | - Elvira Bisbe
- Department of Anaesthesiology, Parc de Salut Mar, Barcelona, Spain
| | | | - Maria J Colomina
- Department of Anaesthesiology, Hospital Universitario de Bellvitge, Barcelona, Spain
- Universidad de Barcelona, Barcelona, Spain
| | - Ángel Becerra-Bolaños
- Department of Anaesthesiology, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - María Bermúdez-López
- Department of Anaesthesiology, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Cristina Massa-Gómez
- Department of Anaesthesiology, Hospital Central de la Cruz Roja, San José y Santa Adela, Madrid, Spain
| | | | - Ana Solar-Herrera
- Department of Anaesthesiology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Hanna Pérez-Chrzanowska
- Department of Anaesthesiology, Hospital Cantoblanco, Hospital Universitario La Paz, Madrid, Spain
| | - Carlos Yárnoz
- Department of Anaesthesiology, Hospital Universitario Donostia, San Sebastián, Spain
| | | | | | - David Fabián-González
- Department of Anaesthesiology, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Jorge Bellver
- Department of Anaesthesiology, Hospital Universitario Dr Peset, Valencia, Spain
| | | | | | - Alfredo Abad-Gurumeta
- Department of Anaesthesiology, Hospital Universitario Infanta Leonor, Madrid, Spain
- Spanish Perioperative Audit and Research Network (RedGERM), Zaragoza, Spain
| | | | - César Aldecoa
- Spanish Perioperative Audit and Research Network (RedGERM), Zaragoza, Spain
- Department of Anaesthesiology, Hospital Universitario Rio Hortega, Valladolid, Spain
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Rodríguez Reveggino B, Becerra-Bolaños Á. Transitional Justice after the COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:12388. [PMID: 36231689 PMCID: PMC9564522 DOI: 10.3390/ijerph191912388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has been a real challenge for health systems and public policies. Both the pandemic and the measures taken to mitigate it have affected the freedoms and rights of the different sectors of society, especially the most vulnerable ones, and have increased the already existing structural inequalities. Consequently, the pandemic must be analyzed from the perspective of human rights. Transitional Justice (TJ) has proven to be useful after conflict situations, helping societies to confront abuses perpetrated and to find solutions for the future, as well as repairing damages that have arisen as a consequence of these conflicts in different areas. Thus, TJ processes have been successfully used after armed conflicts and during peace negotiations, to respond to abuses perpetrated in consolidated democracies, and even after environmental crises. Therefore, the creation of a "Truth and Reconciliation Commission for the COVID-19 pandemic", which launches the TJ processes of truth, justice, reparation and guarantees of non-repetition can help to find solutions to conflicts arising from the pandemic in a simple way. In addition, it would establish the foundations to prevent the violation of human rights in similar situations to come.
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Affiliation(s)
- Bruno Rodríguez Reveggino
- Inter-American Court of Human Rights, San José 6906-1000, Costa Rica
- Faculty of Law, Universidad Tecnológica del Perú, Arequipa 04001, Peru
| | - Ángel Becerra-Bolaños
- Department of Anesthesiology and Intensive Care Unit, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain
- Department of Medical and Surgical Sciences, Faculty of Health Sciences Universidad de Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
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Anez C, Becerra-Bolaños Á, Vives-Lopez A, Rodríguez-Pérez A. Cardiopulmonary Resuscitation in the Prone Position in the Operating Room or in the Intensive Care Unit: A Systematic Review. Anesth Analg 2021; 132:285-292. [PMID: 33086246 PMCID: PMC7785711 DOI: 10.1213/ane.0000000000005289] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The prone position is commonly used in certain surgical procedures and to improve oxygenation in mechanically ventilated patients with acute respiratory distress syndrome (ARDS). Cardiorespiratory arrest (CRA) in this position may be more challenging to treat because care providers trained in conventional cardiopulmonary resuscitation (CPR) may not be familiar with CPR in the prone position. The aim of this systematic review is to provide an overview of current evidence regarding the methodology, efficacy, and experience of CPR in the prone position, in patients with the airway already secured. The search strategy included PubMed, Scopus, and Google Scholar. All studies published up to April 2020 including CRA or CPR in the prone position were included. Of the 268 articles located, 52 articles were included: 5 review articles, 8 clinical guidelines in which prone CPR was mentioned, 4 originals, 27 case reports, and 8 editorials or correspondences. Data from reviewed clinical studies confirm that CPR in the prone position is a reasonable alternative to supine CPR when the latter cannot be immediately implemented, and the airway is already secured. Defibrillation in the prone position is also possible. Familiarizing clinicians with CPR and defibrillation in the prone position may improve CPR performance in the prone position.
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Affiliation(s)
- Cristobal Anez
- From the Department of Anesthesiology, Hospital Universitario de Tarragona Joan XXIII, Tarragona, Spain.,Department of Surgery, Rovira i Virgili University, Tarragona, Spain
| | - Ángel Becerra-Bolaños
- Department of Anesthesiology, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Ariadna Vives-Lopez
- From the Department of Anesthesiology, Hospital Universitario de Tarragona Joan XXIII, Tarragona, Spain.,Department of Surgery, Rovira i Virgili University, Tarragona, Spain
| | - Aurelio Rodríguez-Pérez
- Department of Anesthesiology, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain.,Department of Medical and Surgical Sciences, University of Las Palmas de Gran Canaria, Gran Canaria, Spain
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