RESUMO

BACKGROUND AND OBJECTIVES: It has been demonstrated that smoking increases pain perception; however the effect of smoking on perception of pain during venous cannulation is not known. The purpose of this study is to determine whether or not smoking has an effect on pain perception due to peripheral venous cannulation. METHODS: 220 patients scheduled to have elective surgery were enrolled in the study and were divided into two groups (Group S and C, n = 110 for each) according to their smoking habits. Numerical rating scale was introduced to the patients and then peripheral venous cannulation at the dorsum of the hand was made with a 20 G intracath. Pain perception of the patients was scored by subsequent numerical rating scale questioning. RESULTS: The demographic characteristics of the groups were identical. Numerical rating scale scores in Group S and C were 3.31 ± 1.56 and 1.65 ± 1.23, respectively (p < 0.001). CONCLUSION: Pain perception due to peripheral venous cannulation is higher in smokers. Future studies on pain treatment should consider the smoking habits of patients. .

JUSTIFICATIVA E OBJETIVOS: Sabe-se que o tabagismo aumenta a percepção de dor; porém, o efeito do tabagismo sobre a percepção da dor durante o cateterismo venoso não é conhecido. O objetivo deste estudo foi determinar se o tabagismo tem ou não algum efeito sobre a percepção da dor durante a punção venosa periférica. MÉTODOS: Foram incluídos no estudo 220 pacientes agendados para cirurgia eletiva randomicamente alocados em dois grupos: Grupo S (n = 110) e Grupo C (n = 110), de acordo com seus hábitos tabagísticos. Os pacientes foram instruídos sobre o uso da escala numérica de classificação da dor e, em seguida, a punção venosa periférica foi feita no dorso da mão com um cateter de calibre 20G (Intracath(r)). A percepção de dor dos pacientes foi posteriormente registrada de acordo com os escores da escala numérica. RESULTADOS: As características demográficas dos grupos eram idênticas. Os escores da escala numérica de dor dos grupos S e C foram 3,31 ± 1,56 e 1,65 ± 1,23, respectivamente (p < 0,001). CONCLUSÃO: A percepção da dor por causa da punção venosa periférica é maior em fumantes. Estudos futuros sobre o tratamento da dor devem considerar os hábitos tabagísticos dos pacientes. .

JUSTIFICACIÓN Y OBJETIVOS: Se sabe que el tabaquismo aumenta la percepción de dolor; sin embargo, el efecto del tabaquismo sobre la percepción del dolor durante el cateterismo venoso no se conoce. El objetivo de este estudio fue determinar si el tabaquismo tiene o no algún efecto sobre la percepción del dolor durante la punción venosa periférica. MÉTODOS: Fueron incluidos en el estudio 220 pacientes programados para cirugía electiva aleatoriamente ubicados en 2 grupos: grupo S (n = 110) y grupo C (n = 110), de acuerdo con sus hábitos tabáquicos. A los pacientes se les informó sobre el uso de la escala numérica de clasificación del dolor y a continuación se realizó la punción venosa periférica en el dorso de la mano con un catéter de calibre 20 G (Intracath(r)). La percepción de dolor de los pacientes fue posteriormente registrada de acuerdo con las puntuaciones de la escala numérica. RESULTADOS: Las características demográficas de los grupos eran idénticas. Las puntuaciones de la escala numérica de dolor de los grupos S y C fueron 3,31 ± 1,56 y 1,65 ± 1,23 respectivamente (p < 0,001). CONCLUSIÓN: La percepción del dolor por punción venosa periférica es mayor en los fumadores. Estudios futuros sobre el tratamiento del dolor deben tener en cuenta los hábitos tabáquicos de los pacientes. .

Assuntos

RESUMO

BACKGROUND AND OBJECTIVES: It has been demonstrated that smoking increases pain perception; however the effect of smoking on perception of pain during venous cannulation is not known. The purpose of this study is to determine whether or not smoking has an effect on pain perception due to peripheral venous cannulation. METHODS: 220 patients scheduled to have elective surgery were enrolled in the study and were divided into two groups (Group S and C, n=110 for each) according to their smoking habits. Numerical rating scale was introduced to the patients and then peripheral venous cannulation at the dorsum of the hand was made with a 20G intracath. Pain perception of the patients was scored by subsequent numerical rating scale questioning. RESULTS: The demographic characteristics of the groups were identical. Numerical rating scale scores in Group S and C were 3.31±1.56 and 1.65±1.23, respectively (p<0.001). CONCLUSION: Pain perception due to peripheral venous cannulation is higher in smokers. Future studies on pain treatment should consider the smoking habits of patients.

RESUMO

La cateterización venosa central de la vena subclavia que utiliza reparos anatómicos, es empleada rutinariamente en la unidad de cuidados intensivos. Sin embargo, la técnica guiada por ultrasonido en tiempo real, se ha convertido en una de las 10 prácticas más seguras que mejoran la calidad de la atención en los pacientes críticos. Todavía existe cierta incertidumbre al comparar ambos métodos. Se realizó una revisión de la literatura en las bases de datos PUBMED y EMBASE desde 1985 al 2013, con el objetivo de proveer estudios que utilicen la novedosa técnica de cateterización de la vena subclavia guiada por ultrasonido, así como recomendaciones de su utilización. Se encontraron un total de 102 artículos, tres metaanálisis y dos guías de cateterización venosa central por ultrasonido. El método guiado por ecografía es una técnica promisoria, con una creciente utilización en recién nacidos, niños y adultos. La mayoría de la evidencia demuestra mejores tasas de efectividad, así como disminución del número de complicaciones en comparación con la técnica de reparos anatómicos. Las recomendaciones actuales son las de utilizar el método estático y dinámico para la cateterización; se plantea que este último no debe ser realizado durante la emergencia(AU)

Central venous catheterisation of the subclavian vein using anatomical repairs is routinely used in the intensive care unit. However, ultrasound-guided real-time technique has become one of the 10 safest practices that improve the quality of care in critically ill patients. There is still some uncertainty when comparing both methods. A review of the literature in PubMed and EMBASE databases was performed from 1985 to 2013, with the objective of providing studies using the novel technique of catheterisation of the subclavian vein under ultrasound guidance and recommending its use. A total of 102 articles, three meta-analyzes and two ultrasound-guided subclavian venous catheterisations were found. The ultrasound-guided method is a promising technique, with an increasing use in newborns, children, and adults. Most evidence shows better success rates and fewer complications compared with the technique of anatomical repairs. Current recommendations are to use static and dynamic method for catheterisation; it is argued that the latter should not be performed during the emergency(AU)

Assuntos

RESUMO

La cateterización venosa central de la vena subclavia que utiliza reparos anatómicos, es empleada rutinariamente en la unidad de cuidados intensivos. Sin embargo, la técnica guiada por ultrasonido en tiempo real, se ha convertido en una de las 10 prácticas más seguras que mejoran la calidad de la atención en los pacientes críticos. Todavía existe cierta incertidumbre al comparar ambos métodos. Se realizó una revisión de la literatura en las bases de datos PUBMED y EMBASE desde 1985 al 2013, con el objetivo de proveer estudios que utilicen la novedosa técnica de cateterización de la vena subclavia guiada por ultrasonido, así como recomendaciones de su utilización. Se encontraron un total de 102 artículos, tres metaanálisis y dos guías de cateterización venosa central por ultrasonido. El método guiado por ecografía es una técnica promisoria, con una creciente utilización en recién nacidos, niños y adultos. La mayoría de la evidencia demuestra mejores tasas de efectividad, así como disminución del número de complicaciones en comparación con la técnica de reparos anatómicos. Las recomendaciones actuales son las de utilizar el método estático y dinámico para la cateterización; se plantea que este último no debe ser realizado durante la emergencia.

Central venous catheterisation of the subclavian vein using anatomical repairs is routinely used in the intensive care unit. However, ultrasound-guided real-time technique has become one of the 10 safest practices that improve the quality of care in critically ill patients. There is still some uncertainty when comparing both methods. A review of the literature in PubMed and EMBASE databases was performed from 1985 to 2013, with the objective of providing studies using the novel technique of catheterisation of the subclavian vein under ultrasound guidance and recommending its use. A total of 102 articles, three meta-analyzes and two ultrasound-guided subclavian venous catheterisations were found. The ultrasound-guided method is a promising technique, with an increasing use in newborns, children, and adults. Most evidence shows better success rates and fewer complications compared with the technique of anatomical repairs. Current recommendations are to use static and dynamic method for catheterisation; it is argued that the latter should not be performed during the emergency.

Assuntos

RESUMO

OBJECTIVES: To compare the landmark-guided technique versus the ultrasound-guided technique for internal jugular vein cannulation in spontaneously breathing patients. METHODS: A total of 380 patients who required internal jugular vein cannulation were randomly assigned to receive internal jugular vein cannulation using either the landmark- or ultrasound-guided technique in Bursa, Uludag University Faculty of Medicine, between April and November, 2008. Failed catheter placement, risk of complications from placement, risk of failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization and the demographics of each patient were recorded. RESULTS: The overall complication rate was higher in the landmark group than in the ultrasound-guided group (p < 0.01). Carotid puncture rate and hematoma were more frequent in the landmark group than in the ultrasound-guided group (p < 0.05). The number of attempts for successful placement was significantly higher in the landmark group than in the ultrasound-guided group, which was accompanied by a significantly increased access time observed in the landmark group (p < 0.05 and p < 0.01, respectively). Although there were a higher number of attempts, longer access time, and a more frequent complication rate in the landmark group, the success rate was found to be comparable between the two groups. CONCLUSION: The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of immediate complications.

Assuntos

RESUMO

OBJECTIVES: To compare the landmark-guided technique versus the ultrasound-guided technique for internal jugular vein cannulation in spontaneously breathing patients. METHODS: A total of 380 patients who required internal jugular vein cannulation were randomly assigned to receive internal jugular vein cannulation using either the landmark- or ultrasound-guided technique in Bursa, Uludag University Faculty of Medicine, between April and November, 2008. Failed catheter placement, risk of complications from placement, risk of failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization and the demographics of each patient were recorded. RESULTS: The overall complication rate was higher in the landmark group than in the ultrasound-guided group (p < 0.01). Carotid puncture rate and hematoma were more frequent in the landmark group than in the ultrasound-guided group (p < 0.05). The number of attempts for successful placement was significantly higher in the landmark group than in the ultrasound-guided group, which was accompanied by a significantly increased access time observed in the landmark group (p < 0.05 and p < 0.01, respectively). Although there were a higher number of attempts, longer access time, and a more frequent complication rate in the landmark group, the success rate was found to be comparable between the two groups. CONCLUSION: The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of immediate complications.

Assuntos