QUALI TATI VE AND QUANTI TATI VE ASPECTS OF
PAI N I N LATERAL POSTERI OR THORACOTOMY PATI ENTS
1Th aiza Teix eir a Xav ier2 Gilson de Vascon celos Tor r es3 Ver a Mar ia da Rocha4
Xav ier TT, Tor r es GV, Rocha VM. Qualit at ive and quant it at iv e aspect s of pain in lat eral post er ior t hor acot om y pat ient s. Rev Lat ino- am Enfer m agem 2 0 0 6 set em br o- out ubr o; 1 4 ( 5 ) : 7 0 8 - 1 2 .
Descr ipt iv e st u dy t h at pr oposed t o com par e t h e qu alit at iv e an d qu an t it at iv e beh av ior of t h e pain in lat er al post er ior t hor acot om y pat ient s. The sam ple w as consist ed of 18 indiv iduals w it h an av er age age of 44 year s. The inst r um ent s used w er e physiot her apy evaluat ion for m , num er ical pain scale and McGill quest ionnair e for pain. The pain on t he num er ical pain scale w as consider ed m oder at e( 5) for bot h sex es. The descr ipt or s of t h e McGill qu est ion n air e ch oosen by t h e pat ien t s w it h h igh er f r equ en cy w er e: in t h e sen sor ial com pon en t , beat 4, point ed1, shock2, final and pull2; in t he afet iv e com ponent , t ir ed1, bor ed1, punishald1 and m iser able1 and in t he evaluat ive com ponent w as flat . The char act er ist ics of pain in t he sensor ial gr oup w er e m or e evident s on m ale gr oup. No significant st at ist ical difefer ences w er e obser v ed bet w een quant it at iv e answ er s concer ning pain bet w een t he m en and w om en. On t he qualit at iv e aspect s , w as obser v ed an pr edom inancy of t he sam e d escr ip t or s of p ain in af et iv e com p on en t f or b ot h sex es. Pain in t en sit y w as cat eg or ized as m od er at e. No si g n i f i can t st at i st i cal d i f f er en ce w er e ob ser v ed b et w een t h e p ai n o n t h e p ost - op er at or y l at er al p o st er i or t hor acot om y . These dat a dem onst r at e a necessit y for an analy sis w it h a lar ger st udy gr oup.
DESCRI PTORS: t h or acot om y ; pain m easu r em en t
ASPECTOS CUALI TATI VO Y CUANTI TATI VO DEL DOLOR DE
PACI ENTES SOMETI DOS A LA TORACOTOMI A POSTERO- LATERAL
Est u d io d escr ip t iv o q u e h a d et er m in ad o com p ar ar el com p or t am ien t o cu alit at iv o y cu an t it at iv o d el dolor en pacient es som et idos a la Tor acot om ia Post er o Lat er al( TPL) . La m uest r a fue const it uida por 18 ( dieciocho) indiv iduos, siendo 10 ( diez) hom br es y 8 ( ocho) m uj er es con edad m edia de 44 años. Com o inst r um ent o se u t i l i zo l a f i ch a d e ev al u aci o n f i si o t er ap eu t i ca, escal a n u m er i ca m o d er ad a( 5 ) p ar a am b o s l o s sex o s. Lo s descr ipt or es de los cuest ionar ios par a dolor McGill escogidos con m ay or fr ecuencia por los pacient es fuer on: en el com ponent e sensor ial pungent e4, punt ada1, choque2, fina1, t ir ãn2; en el com ponent e afect ivo, cansacial1, m ar eant e1, cast igant e1 y m iser able1 y en el com ponent e ev aluat iv o fue pesada1. Las car act er ist icas del dolor en el gr upo sensor ial fuer on m ais evident es en el gr upo m asculino. No fuer on obser vadas difer encias est adist icas significat ivas ent r e las r espuest as cuant it at ivas del dolor de hom br es y m uj er es. En r elacion al aspect o cualit at ivo fue obser v ado una pr edom inancia de los m ism os descr ipt or es v er bales del com ponent e afect iv o del dolor par a am b os los sex os. La in t en sid ad d el d olor f u e cat eg or izad a com o m od er ad a, n o h u b o d if er en cia est ad ist ica r elev an t e cu an t o al dolor en el post oper at or io de t or acot om ia post er o- lat er al. Est os dat os dan m ar gen par a una analice con casuist ica m ay or .
DESCRI PTORES: t or acot om ía; dim en sión del dolor
ASPECTOS QUALI TATI VO E QUANTI TATI VO DA DOR DE
PACI ENTES SUBMETI DOS À TORACOTOMI A PÓSTERO- LATERAL
Est udo descr it ivo que obj et ivou com par ar o com por t am ent o qualit at ivo e quant it at ivo da dor em pacient es subm et idos à t or acot om ia póst er o- lat er al ( t pl) . A am ost r a foi const it uída por 18 indiv íduos, sendo 10 hom ens e 8 m ulher es com m édia de idade de 44 anos. Com o inst r um ent os, ut ilizou- se a ficha de avaliação fisiot er apêut ica, escala num ér ica da dor e quest ionár io par a dor McGill. A dor na escala num ér ica foi consider ada m oder ada ( 5) par a am bos os sex os. Os descr it or es do quest ionár io par a dor McGill, escolhidos com m aior fr eqüência pelos pacien t es, for am : n o com pon en t e sen sor ial, lat ej an t e4 , pon t ada1 , ch oqu e2 , fin a1 e pu x ão2 ; n o com pon en t e afet ivo, cansat iva1, enj oada1, cast igant e1 e m iser ável1 e no com ponent e avaliat ivo foi chat a1. As car act er íst icas d a d o r n o g r u p o sen so r i al f o r am m ai s ev i d en t es n o g r u p o m ascu l i n o . Não f o r am o b ser v ad as d i f er en ças est at íst icas significant es ent r e as r espost as quant it at ivas da dor de hom ens e m ulher es. No que diz r espeit o ao aspect o qu alit at iv o, obser v ou - se pr edom in ân cia dos m esm os descr it or es v er bais do com pon en t e af et iv o da d or p ar a am b os os sex os. A in t en sid ad e d olor osa f oi cat eg or izad a com o m od er ad a, n ão h ou v e d if er en ça est at íst ica significat iva quant o à dor no pós- oper at ór io de t or acot om ia póst er o- lat er al. Esses dados dão m ar gem par a a análise com casuíst ica m aior .
DESCRI TORES: t or acot om ia; m edição da dor
1 Ar t icle ext ract ed fr om t he m ast er ’s t hesis; 2 Physiot herapist , M.Sc. in Healt h Sciences, Facult y, Univer sit y of Sout hw est Bahia; 3 RN, PhD in Fundam ent al Nur sing, Facult y, e- m ail: gvt @ufr net .br ; 4 Physiot her apist , PhD in Physiot her apy. Facult y. Federal Univer sit y of Rio Grande do Nor t e
I NTRODUCTI ON
P
ain assessm ent is a com plex process, w hich ca n o n l y b e p e r f o r m e d b y r e se a r ch e r s b a se d o nr epor t s by v ict im s of t issu e aggr ession . Pr ecision in
pain descr ipt ion is in dicat ed by pat ien t s’ su bj ect iv e
r e p o r t s( 1 ). Pa i n p e r c e p t i o n i s c o n c e i v e d a s a n u n p l e a s a n t s e n s o r y a n d e m o t i o n a l e x p e r i e n c e
a sso ci a t e d w i t h r e a l o r p o t e n t i a l t i ssu e i n j u r y o r
described in t erm s of t his inj ury( 2- 5). Pain is m odulat ed b y co g n i t i o n( 2 , 4 - 5 ), a s w el l a s b y ea ch i n d i v i d u a l ’ s cult ur al and phy sical char act er ist ics and gender( 3).
Alt hough som e researchers rest rict t hem selves
t o assessin g p ain in t er m s of in t en sit y on ly, u sin g
unidim ensional scales, t he pain phenom enon knowingly
involves ot her - sensory and affect - dim ensions, and
t his m ult idim ensional approach is possible by using t he
McGill pain quest ionnair e. This inst r um ent consist s of
78 descr ipt or s dist r ibut ed in four lar ge gr oups( 6). I t s applicat ion in research( 7- 9) has not addressed pain qualit y percept ions in m ale and fem ale pat ient s subm it t ed t o
lat eral post erior t horacot om y ( lpt ) . Scient ific lit erat ure
cont ains count less cit at ions and adapt at ions of t he McGill
q u e s t i o n n a i r e t o d i f f e r e n t l a n g u a g e s , i n c l u d i n g
Por t u g u ese, I t al i an , Sp an i sh , Nor w eg i an , Ger m an ,
Arabic and French. I t s use in different clinical sit uat ions
has dem onst rat ed t hat it is a reliable and effect ive pain
assessm ent inst r um ent( 7- 9).
Know ing t hat m ost pat ient s r epor t acut e pain
i n t h e p o st o p er a t i v e p h a se a n d st a r t i n g f r o m t h e
p r em ise t h at t h er e ar e q u an t it at iv e an d q u alit at iv e
d i f f e r e n ce s i n p a i n p e r ce p t i o n b e t w e e n m e n a n d
w om en subm it t ed t o lpt , t his st udy aim s t o ver ify pain
int ensit y and charact erize it by applying t he num er ical
scale and t he McGill pain quest ionnair e, as it is not
clear w h ich pain com pon en t s an d v er bal descr ipt or s
ar e m or e r elat ed t o pain der iv ing fr om lpt .
St a r t i n g f r o m t h ese i n i t i a l co n si d er a t i o n s,
ex ist in g gaps in lit er at u r e an d clin ical ex per ien ce in
r espir at or y phy siot herap y, and concer ned about car e
qu alit y an d adequ at e pain t r eat m en t f or pat ien t s in
t h e post oper at iv e per iod af t er lpt , ou r m ain goal in
t his st udy w as t o com par e qualit at ive and quant it at ive
pain behavior in pat ient s subm it t ed t o lat er al post er ior
t h or acot om y, accor din g t o sex .
METHODOLOGY
This descr ipt ive case st udy exam ined t he pain
p h e n o m e n o n i n o r d e r t o g e t t o k n o w i t s n a t u r e ,
com posit ion and qualit at ive and quant it at ive behavior
in pat ient s subm it t ed t o lat eral post er ior t horacot om y.
We used a cont ingency sam ple, consist ing of
18 pat ient s dist r ibut ed in t w o gr oups accor ding t o sex,
t e n m e n a n d e i g h t w o m e n , su b m i t t e d t o l a t e r a l
post er ior t hor acot om y at t he Univer sit y Hospit al Onofr e
Lopes ( HUOL) , locat ed in Nat al/ RN, Br azil. The sam ple
included pat ient s w it h cognit iv e condit ions t o answ er
t he inst rum ent s and w ho w ere w illing t o volunt eer for
par t icipat ion. The m ost fr equent clinical diagnosis in
t h e s t u d y s a m p l e w a s s e q u e l a o f p u l m o n a r y
t u b er cu l o si s, f o u n d i n 3 0 % o f m en an d 3 7 . 5 % o f
w o m en .
Ages r anged fr om 13 t o 61 year s in t he m ale
gr oup ( n = 10) and fr om 29 t o 59 year s in t he fem ale
gr oup ( n = 8) , w it h 44 y ear s as t he m edian in bot h
gr ou ps. Th e pr edom in an t edu cat ion lev el w as basic
educat ion in 50% of m en and 75% of w om en. Ninet y
per cent of m en and 100% of w om en r eceived gener al
an est h esia. Av er ag e d u r at ion of su r g er y w as 4 h in
t h e m ale g r ou p an d 3 h in t h e f em ale g r ou p . Six t y
p e r c e n t o f m e n w e r e s u b m i t t e d t o r i g h t l a t e r a l
post er ior t h or acot om y an d h ad t w o t h or acic dr ain s;
t he ot her 40% w er e subm it t ed t o left lpt , 30% w it h
o n e d r ai n an d 1 0 % w i t h t w o d r ai n s. Sev en t y - f i v e
per cent of w om en w er e subj ect t o r ight lpt , 50 % of
w h om h ad t w o r ig h t t h or acic d r ain s an d 2 5 % on ly
one dr ain, w hile t he 25% subm it t ed t o left lpt had one
left t hor acic dr ain.
Th e p h y siot h er ap eu t ic assessm en t f ile w as
used for general dat a collect ion, and t he num erical pain
sca l e f o r u n i d i m e n si o n a l p a i n a sse ssm e n t . Th i s
inst rum ent consist s of a zero- t o- t en int erval, in which
zero m eans absence of pain and t en t he worst im aginable
pain. This scale is also classified as m ild pain ( 0- 3) ,
m oderat e pain ( 4- 7) and severe pain ( 8- 10) .
For t he m ult idim ensional appr oach, w e used
t h e McGill Pain Qu est ion n air e, w h ich con sist s of 7 8
v er b al d escr ip t or s in 4 lar g e g r ou p s ( 1 sen sor y, 2
-a f f e c t , 3 - e v -a l u -a t i v e -a n d 4 - m i s c e l l -a n e o u s ) -a n d
d ist r ib u t ed in 2 0 su b g r ou p s. Each d escr ip t or h as a
s p e c i f i c r a n k v a l u e , r a n g i n g f r o m 1 t o 6 a n d
r epr esen t ed in t h e r esu lt s as su bscr ipt f igu r es. Th e
p at ien t ’s d escr ip t or ch oice g av e u s t w o m easu r es:
t he num ber of descr ipt or s chosen and t he pain level,
obt ain ed by addin g u p t h e ch osen descr ipt or s’ r an k
v al u es.
All procedures were carried out aft er approval
by t he UFRN Et hics Com m it t ee and aft er t he signing of
et hical aspect s det erm ined in Resolut ion 196/ 96 by t he
Nat ional Healt h Council( 10). At a t im e when pat ient s were awake, direct ed and com plained of pain at t he int ensive
t herapy unit ( I TU) , we carried out a physiot herapeut ic
assessm ent . Then, we verified t heir pain charact erist ics
t hrough t he num erical scale, which was shown t o t he
pat ient , who chose t he num ber from zero t o t en t hat
best represent ed his/ her pain, and t hrough t he McGill
pain quest ionnaire. During it s applicat ion, t he t herapist
read t he 78 descript ors and t he pat ient eit her chose t he
word or not which best represent ed his/ her pain in each
su bgr ou p of t h e qu est ion n air e. Th u s, all descr ipt or s
chosen by t he pat ient s were regist ered at t he m om ent
t hey felt pain.
D a t a w e r e s u b m i t t e d t o t h e f o l l o w i n g
st at ist ical t est s: Mann- Whit ney U t est ( for t he m ean
num ber of descr ipt or s chosen and t he sum of t hese
descr ipt or s in t he sensor y, affect and evaluat iv e pain
com ponent s) , cor r elat ion t est ( for t he num er ical pain
scale, t h e m ean n u m b er of d escr ip t or s ch osen an d
t h e su m of t h ese d escr ip t or s in t h e sen sor y, af f ect
a n d e v a l u a t i v e p a i n co m p o n e n t s) a n d r e g r e ssi o n
analy sis ( for t he v ar iables num er ical pain scale, age,
d u r at ion of su r g er y, n u m b er of d r ain s an d sid e of
sur ger y ) , using St at ist ic 5. 0. soft w ar e.
RESULTS
First , pain int ensit y was assessed t hrough t he
num er ical pain scale. The m edian found w as 5, bot h
for m en ( 3- 8) and wom en ( 2- 9) , sit uat ing post - lat eral
post erior t horacot om y pain as m oderat e. No significant
cor r elat ion w as f ou n d b et w een d u r at ion of su r g er y
( p= 0. 933) and age ( p= 0. 968) on t he one hand and
t h e n u m er ical pain scale on t h e ot h er. How ev er, w e
found a significant correlat ion ( p= 0.026) bet ween t he
num ber of t horacic drains and t he num erical pain scale.
Num erical scale dat a were also subm it t ed t o regression
analysis, showing t hat m ean pain levels where higher
in case of right t han left lpt .
Qualit at ive pain aspect s were analyzed on t he
basis of t he McGill ver bal descr ipt or s m ost fr equent ly
m en t ion ed by t h e sam ple. Th e su bscr ipt r an k v alu e
(1,2,3,4,5,6) of each verbal descriptor represents the intensity
of each word. Group 4 (m iscellaneous) was not described,
as it is only used to confirm data obtained in the other
t hree groups ( sensory, affect and evaluat ive) .
I n com p on en t 1 - sen sor y ( r ep r esen t ed b y
su b g r o u p s 1 t o 1 0 ) - w e f o u n d t h a n m e n ch o se
descr ipt or s w it h higher r ank v alues t han w om en for
subgr oups 1,3,5,6,7,8,10. For subgr oups 4 and 9, on
t he opposit e, m en chose descr ipt or s w it h low er r ank
v a l u e s t h a n w o m e n . Me n a n d w o m e n o n l y ch o se
descr ipt or s w it h t h e sam e r an k v alu es for su bgr ou p
2, as show n in Table 1.
Ta b l e 1 - Fr e q u e n c y o f m a i n v e r b a l d e s c r i p t o r s
m ent ioned by t he sam ple on t he sensor y, affect and
e v a l u a t i v e c o m p o n e n t s o f t h e M c Gi l l p a i n
quest ionnair e. Nat al/ RN, 2 0 0 4
n i a P s t n e n o p m o c l l i G c M s p u o r g b u
s Women % Men %
y r o s n e S
1 Throbbing4* 62.5 g n i s l u
P 3/
g n i b b o r h
t 4*/
g n it a e b 5 0 2
2 Jumping1*/
g n i h s a l
F 2* 37.5
g n i p m u
J 1*/
g n i h s a l
F 2* 30
3 Boring2 37.5 g n il li r
D 3/
g n i b b a t
S 4/
g n it a n i c n a L 5 0 2
4 Sharp1*/
g n it a r e c a
L 3 37.5Sharp1* 30
5 Cramping4 50 Gnawing3/
g n i h s u r C 5 0 3
6 Pulilng2* 50 Pulilng2*/
g n i h c n e r
W 3 50
7 Scalding3 62.5Burning2/
g n i r a e S 4 0 3
8 Smaritng3 62.5Sitnging4 60
9 Heavy5 50 Aching4 50
0
1 Taut2 50 Spiltitng4 40
t c e f f
A 11 Tiring1* 75 Tiring1* 80
2
1 Sickening1* 75 Sickening1* 80 3
1 Punishing1* 50 Punishing1* 50
5
1 Wretched1* 50 Wretched1* 60
e v it a u l a v
E 16 Annoying1* 37.5Annoying1*/
e m o s e l b u o r
t 2 4
Obser vat ion: * Com m on descr ipt or s for m en and w om en.
* * The subscr ipt num ber s r epr esent t he r ank values for each descr ipt or
Th e f e m a l e g r o u p s d e m o n st r a t e d g r e a t e r
h om og en eit y in t h e ch ar act er izat ion of p ost - lat er al
p ost er ior t h or acot om y p ain , as m en u sed d if f er en t
d escr ip t or s t o r ef er t o t h eir p ain . Men an d w om en
bot h used t he follow ing w or ds in t he sensor y gr oup:
t h r obbin g4, j u m pin g1, flash in g2, sh ar p1 an d pu llin g2, w h ich r ef er t o m ech an ical, t h er m al, v iv id n ess an d
spat ial pr oper t ies of pain in pat ient s w ho suffer ed a
t issue inj ur y dur ing lpt pr ocedur es.
I n com ponent 2 - affect , including subgr oups
11, 12, 13, 14, 15 - w om en and m en char act er ized
p ost - lp t p ain as t ir in g1, sick en in g1, p u n ish in g1 an d w r et ched1. I t w as only in subgr oup 14 t hat m en chose cr u el3 ( 4 0 % ) , w h ile w om en ch ose f ear f u l1 ( 6 2 . 5 % ) . Th e se t e r m s d e scr i b e t h e b e h a v i o r o f t h e a f f e ct
dim ension in t er m s of pain- r elat ed t ension, fear and
n eu r ov eget at iv e r espon ses in pat ien t s su bm it t ed t o
lpt su r gical pr ocedu r es.
I n com ponent 3 - evaluat ive, represent ed by
subgroup 16 - 37.5% of wom en charact erized t heir pain
t r oublesom e2 ( 40% ) . The answ er s m ent ioned in t his group allow individuals t o express a global assessm ent
of t heir pain experience. Aft er having suffered a t issue
inj ur y dur ing sur gical incision for lpt , bot h m en and
wom en expressed t heir pain as annoying.
Th e q u a n t i t a t i v e p a r a m e t e r s ( n u m b e r o f
descr ipt or s chosen and sum of r ank v alues for t hese
descr ipt or s) of t he sensor y, affect and evaluat ive pain
c o m p o n e n t s w e r e c o m p a r e d b e t w e e n m e n a n d
w om en . We n eit h er f ou n d a sig n if ican t cor r elat ion
bet w een t h e n u m ber of descr ipt or s ch osen an d age
( p= 0.193) , dur at ion of sur ger y ( p= 0.517) and num ber
o f d r a i n s ( p = 0 . 7 7 9 ) , n o r b e t w e e n t h e s u m o f
descr ipt or r ank v alues and t he sam e v ar iables, w it h
p= 0. 237, p= 0. 924 and p= 0. 144, r espect iv ely.
I n t ot al, t h e sen sor y com pon en t con sist s of
4 2 d escr i p t o r s, d i st r i b u t ed i n t en su b g r o u p s. On e
descr ipt or w as ch osen in each su bgr ou p ( m ax im u m
t en d escr ip t or s) . Th e m ean n u m b er of d escr ip t or s
chosen by m en w as 8.8 ( st andar d dev iat ion± 2) , and
t h e su m of t h ese d escr ip t or s’ r an k v alu es eq u aled
25.9 ( st andar d deviat ion± 3.5) . For w om en, t he m ean
n u m b e r o f d e scr i p t o r s ch o se n w a s 8 . 6 ( st a n d a r d
dev iat ion± 2) , and t he sum of t hese descr ipt or s’ r ank
v alues w as equal t o 2 3 . 8 ( st andar d dev iat ion± 9 ) . A
com par ison bet w een t hese m ean num ber s ( p= 0.903)
and sum s ( p= 0. 310) for m en and w om en subm it t ed
t o lpt did not reveal st at ist ically significant differences
o n t h e Ma n n - W h i t n e y U t e st . Ta b l e 2 sh o w s t h e
dist r ibut ion of t he num ber of descr ipt or s and sum of
descr ipt or r ank v alues as m ent ioned by t he sam ple.
Table 2 - Dist r ibut ion of num ber and sum of descr ipt or
rank values m ent ioned by t he sam ple on t he sensor y,
a f f e c t a n d e v a l u a t i v e c o m p o n e n t s o f t h e Mc Gi l l
quest ionnair e. Nat al/ RN, 2 0 0 4
The affect com ponent includes 14 descr ipt or s,
dist r ibut ed in five subgr oups. Only one descr ipt or w as
chosen in each subgr oup ( m axim um five descr ipt or s) .
The m ean num ber of descr ipt or s chosen by m en w as
4 . 2 ( s t a n d a r d d e v i a t i o n ± 1 . 5 ) , a n d t h e s u m o f
descr ipt or s equaled 6.2 ( st andar d deviat ion± 4.5) . For
w om en, t he m ean num ber of descr ipt or s chosen w as
4 . 6 ( st an dar d dev iat ion ± 1 ) an d t h e su m of t h ese
d escr i p t o r s t o t a l ed 6 . 7 ( st a n d a r d d ev i a t i o n ± 4 . 5 ) .
Ag a i n , a co m p a r i so n b et w een t h e m ea n n u m b er s
( p= 0.272) and sum s ( p= 0.599) for m en and w om en
in t he affect group did not reveal st at ist ically significant
differ ences on t he Mann- Whit ney U t est .
Th e ev alu at iv e p ain com p on en t con sist s of
fiv e descr ipt or s in one subgr oup. Only one descr ipt or
could be chosen. Men used a descr ipt or w it h a m ean
su m of 2 . 1 ( st an dar d dev iat ion ± 2 ) . Wom en , on t h e
ot her hand chose a descr ipt or w it h a m ean r ank value
sum of 2.5 ( st andar d deviat ion± 2) . , and t he sum of
t h ese d escr i p t o r s’ r a n k v a l u es w a s eq u a l t o 2 3 . 8
( st andar d dev iat ion± 9) . A com par ison bet w een t hese
m ean n u m ber s ( p= 0 . 6 5 7 ) an d t h e r an k v alu e su m s
( p = 0 . 7 1 6 ) a m o n g m e n a n d w o m e n d i d n o t sh o w
st at ist ical significance on t he Mann- Whit ney U t est .
DI SCUSSI ON
I n t h i s st u d y, a co m p a r i so n b e t w e e n t h e
answ er s of m ale and fem ale pat ient s subm it t ed t o lpt
r ev ealed a t endency t o choose t he sam e descr ipt or s
i n t h e a f f e ct co m p o n e n t . I n a m a x i m u m o f f i v e
descr ipt or s, m en and w om en chose t he sam e t er m s
i n f o u r ca se s. I n t h e e v a l u a t i v e co m p o n e n t , t h e
descr ipt or w om en m ost m en t ion ed w as also on e of
t he t er m s m ost m ent ioned by m en. How ev er, in t he
s e n s o r y c o m p o n e n t , w h e r e a m a x i m u m o f t e n
descr ipt or s cou ld be ch osen , bot h gr ou ps ch ose t h e
sam e t er m s in only four cases. The sam ple descr ibed
t he qualit at ive aspect s of lpt - r elat ed pain as: t hr obbing,
j u m p in g , f lash in g , sh ar p , p u llin g , t ir in g , sick en in g ,
punishing, w r et ched and annoy ing.
Qualit at ive pain aspect s have been exam ined
in research on acut e pain in pat ient s w it h ort hopedic,
gy n ecologic and sur gical in j ur ies. Pat ient s v ict im s of
fr act u r es, ch afin g, cu t s, am on g ot h er in j u r ies, m or e
fr equent ly chose t he follow ing descr ipt or s: t hr obbing,
sh a r p , a ch i n g , t h r o b b i n g , p o u n d i n g , so r e, t en d er,
bur ning, hot , st abbing, cr ushing and st inging( 11). Ther e w as a clear sim ilarit y in descript ors chosen by pat ient s
s t n e i t a P
s r o t p i r c s e d f o º
N Sumofdescriptorrank
s e u l a v n
e
M Women Men Women
E
S AF AV SE AF AV SE AF AV SE AF AV
1 9 3 1 8 5 1 23 4 1 22 5 1
2 8 2 1 6 3 1 22 2 2 15 3 1
3 10 5 1 8 5 1 29 8 2 25 9 4
4 9 5 1 10 5 1 28 7 4 22 6 1
5 9 5 1 10 5 5 28 7 4 22 6 1
6 8 4 1 10 5 1 21 5 1 28 5 2
7 6 4 1 8 4 1 22 4 1 23 8 2
8 8 4 1 9 5 1 25 4 2 23 12 5
9 10 5 1 - - - 37 10 2 - -
-0
1 10 5 1 - - - 22 7 1 - -
-n a e
M 8,8 4,2 1 8,6 4,6 1 25,9 6,2 2,123,8 6,7 2,5
Pain com ponent s: Sensor y ( SE) = Descr ipt or s Max. n. 10, Sum of r ank values Max n. 42.
w it h t he sam e inj ur y t ype: pat ient s w it h fr act ur es chose
h o t / b u r n i n g , w h i l e p a t i e n t s w i t h c h a f i n g c h o s e
t h r o b b i n g . A n o t h e r s t u d y( 1 2 ) a s s e s s e d p a t i e n t s su bm it t ed t o su r gical in t er v en t ion s an d f ou n d m or e
request s for analgesics in pat ient s choosing descript ors
w it h h ig h er p ain r at in g in d ices. Th e m ost f r eq u en t
t er m s in t hat st udy w er e: j um ping, pr icking, pr essing,
pulling, heavy and t ender in t he sensor y com ponent ;
t ir in g an d ex h au st in g in t h e af f ect com p on en t an d
annoy ing in t he ev aluat iv e gr oup.
Ye t a n o t h e r r e se a r ch( 1 3 ) r e v e a l e d si m i l a r r esult s t o our st udy, evidencing t hat bet w een 70 and
80% of pat ient s subm it t ed t o t hor acot om y indicat ed
sever e or m oder at e pain. Pain int ensit y w as com par ed
bet w een pat ien t s su bm it t ed t o lat er al post er ior an d
a n t e r i o r t h o r a c o t o m y p a t i e n t s , u s i n g t h e v i s u a l
analogue scale, and t he m ost sev er e pain w as found
in lpt pat ient s( 14). Research show s t he int ensit y of pain char act er ist ics, ser v ing as a par am et er t o v er ify t he
e f f i ca cy o f p o st o p e r a t i v e p a i n r e l i e f m e d i ca t i o n .
St u d i e s e v a l u a t e d t h e e f f e c t o f t w o a n a l g e s i c s ,
bupivacaine and lidocaine, assessing pain by t he visual
an alogu e scale an d t h e dem an d f or an algesics, an d
f ou n d n o st at ist ically sig n if ican t d if f er en ce in p ain
i n t e n s i t y b e t w e e n t h e t w o s t u d y g r o u p s( 1 5 - 1 6 ).
Re s e a r c h e r s ’ e f f o r t s t o p r o m o t e p r e - a n d
p o s t o p e r a t i v e p a i n c o n t r o l a r e f u n d a m e n t a l f o r
p at ien t s’ r ecov er y.
CONCLUSI ONS
Pa i n i n t e n s i t y a f t e r l p t w a s c o n s i d e r e d
m od er at e i n accor d an ce w i t h t h e n u m er i cal scal e.
A l t h o u g h t h e y u n d e r w e n t t h e s a m e s u r g i c a l
p r o ce d u r e , m e n a n d w o m e n p r e se n t e d d i f f e r e n t
descr ipt or s f or t h e sen sor y com pon en t of t h is pain .
Th i s w a s n o t f o u n d f o r t h e a f f e ct a n d e v a l u a t i v e
c o m p o n e n t s . Th e Mc Gi l l d e s c r i p t o r s t h r o b b i n g4, j u m p i n g1, f l a s h i n g2, s h a r p1, p u l l i n g2, t i r i n g1, sick ening1, punishing1, w r et ched1 and annoy ing1 w er e u sed i n co m m o n o n t h e t h r ee co m p o n en t s o f t h e
McGill pain qu est ion n air e. Th is sh ow s a t en den cy in
t h e q u a l i t a t i v e b e h a v i o r o f p a i n d u e t o l p t . A
c o m p a r i s o n o f q u a n t i t a t i v e M c G i l l p a r a m e t e r s
b et w een m en an d w om en d id n ot r ev eal st at ist ical
differ ences. One of t he m ain lim it at ions t o t his st udy
is t h e sm all n u m b er of su b j ect s an d d if f icu lt ies t o
cont r ol fem ale hor m onal fact or s, w hich can int er fer e
in pain r espon ses.
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