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Resumo Objetivos Realizar o cognitive debriefing e testar a fidedignidade do Non-Communicative Patient’s Pain Instrument (NOPPAIN). Métodos Estudo metodológico de verificação do NOPPAIN (versão brasileira) adaptado à cultura brasileira. Cognitive debriefing: participaram 56 profissionais de saúde e cuidadores; sua tarefa foi avaliar e fazer sugestões sobre a equivalência e adequação do NOPPAIN-Br. A versão final, intitulada “NOPPAIN-Versão brasileira” foi submetida a um Comitê de Especialistas (n=8). Foi calculado o Índice de Validade de Conteúdo. Para testar a fidedignidade três observadores aplicaram a nova versão do NOPPAIN em uma amostra (n=171) de pessoas idosas com demência e comunicação prejudicada onde foi calculada a concordância interobservadores - KAPPA. Resultados O NOPPAIN-Br foi alterado em palavras tais como: “não comunicativo”, “enfermeiro”, “deve fazer” e “paciente”. A equivalência da nova versão com o instrumento original foi reforçada (IVC>0,80). A concordância entre observadores foi quase perfeita para a “Lista de Verificação de Atividades I” (Kappa>0,80), “Comportamentos de dor II: Presença” (Kappa>0,80) e “Comportamentos de dor III: Intensidade” (Kappa>0,80; ICCsingle>0,75). Foi observada evidência de alta confiabilidade (ICC single>0,75) para todas subescalas do instrumento e pontuação total. A melhor concordância foi para intensidade geral da dor (ICCsingle 0,97). Conclusão O NOPPAIN-Br é equivalente ao instrumento original e fidedigno, podendo ser disponibilizado para novas pesquisas e avaliação da dor em brasileiros com demência e comunicação prejudicada.

ABSTRACT Introduction. Assessment and management of pain in older adults can be challenging, with persistent pain prevalence ranging from 25% to 80%, especially in long-term care homes (LTCH), where most seniors are unable to verbalize their pain. This article describes the implementation of the Registered Nurses’ Association of Ontario (RNAO) Assessment and Management of Pain (Third Edition) best practice guideline (BPG) in a LTCH in Toronto, Canada. Methodology. Using mixed descriptive study methodology, this 391-bed home housing older adults over 80 years implemented the Pain guideline using the knowledge-to-action framework and audit procedures to evaluate the impact of implementing this guideline. Key implementation activities included educating residents, families, and staff about pain while integrating validated pain screening and assessment tools into practice. A mixed methods approach of qualitative and quantitative data was utilized to monitor improvements in clinical and organizational outcomes. Results. The impact of implementing Pain BPG is: improved utilization of pain assessment and management tools, reduced incidence of worsening pain, improved pain scores and improved resident quality of life. The structured and integrated, evidence-based approaches to pain assessment and management reflected that long-term care residents don’t have to live with pain regularly, which leads to a better quality of life and resident/family satisfaction. Discussion. In conjunction with the structured approach of the knowledge-to-action framework and the Pain BPG, the LTCH utilized tailored approaches to meet the needs of their resident population. Recognizing the unique needs of seniors in a residential setting, organizational structural facilitators, and barriers and cultural needs, the LTCH developed multi-modal approaches based on a person and family-centred approach. This evidence-based and resident-focused approach was the key to the successful implementation and subsequent outcomes that were resultant. Conclusion. The systematic implementation of the RNAO pain BPG and the utilization of the knowledge-to-action framework was shown to improve resident outcomes, improve organizational processes and generate staff satisfaction. Participation and engagement of residents, their families and health professionals in the process was one of the greatest facilitators. Keywords: Practice Guidelines as Topic; Implementation Science; Long-Term Care; Nursing Homes; Frail Elderly; Pain Measurement; Pain Management; Quality Improvement RESUMEN Introducción. La evaluación y el tratamiento del dolor en los adultos mayores puede constituir un desafío, con una prevalencia de dolor persistente que oscila entre el 25 al 80%, especialmente en residencias de cuidados a largo plazo (LTCH por sus siglas en inglés), donde la mayoría de los ancianos son incapaces de verbalizar su dolor. Este artículo describe la aplicación de la guía de buenas prácticas (BPG por sus siglas en inglés) de la Asociación de Enfermeras Registradas de Ontario (RNAO por sus siglas en inglés) para la Evaluación y el Tratamiento del Dolor (Tercera Edición) en un centro de cuidados a largo plazo de Toronto, Canadá. Metodología. Utilizando una metodología de estudio descriptivo mixto, esta residencia de 391 camas que alberga a adultos mayores de 80 años implementó la guía sobre el dolor, utilizando el marco de conocimiento a la acción, al igual que procedimientos de auditoría, para evaluar el impacto de la implementación de la guía. Entre las actividades clave de la implementación se incluyeron la educación de los residentes, las familias y el personal sobre el dolor, así como la integración en la práctica de herramientas validadas de detección y evaluación del dolor. Se utilizó un enfoque metodológico mixto de datos cualitativos y cuantitativos para supervisar las mejoras en los resultados clínicos y organizativos. Resultados. El impacto de la implementación de la BPG sobre el dolor es: mejoría de la utilización de las herramientas de evaluación y manejo del dolor, reducción en la incidencia de empeoramiento del dolor, mejoría en puntuaciones del dolor, así como en la calidad de vida de los residentes. Los enfoques estructurados e integrados basados en la evidencia, dirigidos a la evaluación y manejo del dolor reflejaron que los residentes del LTCH no deben vivir con dolor habitualmente, lo que conduce a una mejor calidad de vida y satisfacción del residente y/o familia. Discusión. Junto con el enfoque estructurado del marco del conocimiento a la acción y la BPG del dolor, la residencia de cuidados a largo plazo utilizó enfoques adaptados para satisfacer las necesidades de su población residente. Reconocer las necesidades únicas de los mayores en un entorno residencial, los facilitadores estructurales organizativos y las Este enfoque basado en la evidencia y centrado en el residente fue la clave del éxito de la implantación y de los subsecuentes resultados obtenidos. Conclusiones. Se evidenció que la implantación sistemática de la BPG del dolor de la RNAO y la utilización del marco del conocimiento a la acción mejoraron los resultados de los residentes, los procesos organizativos y generaron mayor satisfacción en el personal. La participación y el compromiso de los residentes, sus familias y los profesionales de salud fue uno de los mayores facilitadores en el proceso. Palabras clave: Guías de Práctica Clínica como Asunto; Ciencia de la Implementación; Cuidados a Largo Plazo; Casas de Salud; Anciano Frágil; Dimensión del Dolor; Manejo del Dolor, Mejoramiento de la Calidad. RESUMO Introdução. A avaliação e o tratamento da dor em idosos podem ser desafiadores, com a prevalência de dor persistente variando de 25 a 80%, especialmente em hospitais de longa permanência (LTCH por suas siglas em inglês), onde a maioria dos idosos não consegue verbalizar sua dor. Este artigo descreve a aplicação do guia de boas práticas (BPG por suas siglas em inglês) da Associação de Enfermeiras Registradas de Ontário (RNAO por suas siglas em inglês) para Avaliação e Tratamento da Dor (Terceira Edição) em uma instituição de cuidados de longo prazo em Toronto, Canadá. Metodologia. Utilizando uma metodologia de estudo descritiva, essa casa com 391 leitos que acolhe idosos com mais de 80 anos de idade implementou o guía para o manejo da dor, utilizando a estrutura do conhecimento para a ação, bem como procedimentos de auditoria, para avaliar o impacto da implementação do guia. As principais atividades de implementação incluíram a educação dos residentes, famílias e funcionários sobre a dor, bem como a integração na prática de ferramentas validadas de detecção e avaliação da dor. Foi utilizada uma abordagem metodológica mista de dados qualitativos e quantitativos para monitorar melhorias nos resultados clínicos e organizacionais. Resultados. O impacto da implementação do BPG para o manejo da dor é: melhoria na utilização de ferramentas de avaliação e manejo da dor, redução na incidência de piora da dor, melhora nos escores de dor, bem como na qualidade de vida dos residentes. Abordagens estruturadas e integradas baseadas em evidências, destinadas à avaliação e manejo da dor refletiram que os residentes do LTCH não devem conviver rotineiramente com a dor, levando à melhoria da qualidade de vida e à satisfação dos residentes e/ou familiares. Discussão. Juntamente com a abordagem articulada da estrutura do conhecimento para a ação e o BPG para o manejo da dor, a cassa de cuidados de longo prazo utilizou abordagens adaptadas para satisfazer as necesidades da sua população residente. O reconhecimento das necessidades únicas dos idosos num ambiente residencial, dos facilitadores estruturais organizacionais e das barreiras e necessidades culturais, permite que os LTCH desenvolvam abordagens multimodais, centradas na pessoa e na família. Esta abordagem baseada em evidências e centrada no residente foi a chave para o sucesso da implementação e os resultados subsequentes obtidos. Conclusões. Ficou evidente que a implementação sistemática do BPG para o manejo da dor da RNAO e o uso da estrutura do conhecimento para a ação melhoraram os resultados dos residentes e os processos organizacionais, e geraram maior satisfação do pessoal. A participação e o comprometimento dos residentes, seus familiares e profissionais de saúde foi um dos maiores facilitadores do processo. Palavras-chave: Guias de Prática Clínica como Assunto; Ciência da Implementação; Assistência de Longa Duração; Casas de Saúde; Idoso Fragilizado; Medição da Dor; Manejo da Dor; Melhoria de Qualidade

RESUMEN Introducción. El dolor es definido por la Asociación Internacional para el Estudio del Dolor (IASP, por su sigla en inglés) como una experiencia sensorial y emocional desagradable. Por tanto, la función que cumple la enfermería en esta quinta constante vital es fundamental. El objetivo de este estudio fue describir el nivel de conocimientos y actitudes de enfermeras profesionales y auxiliares respecto al dolor en una institución asistencial de tercer nivel de atención de Bucaramanga, Colombia. Metodología. Estudio descriptivo de corte transversal, con una muestra conformada por 162 participantes. Se utilizó el cuestionario Knowledge and Attitudes Survey Regarding Pain. Criterios de inclusión: enfermeras profesionales y auxiliares de enfermería con mínimo tres meses en el servicio; criterios de exclusión: estudiantes de enfermería y enfermeras con labores formativas y no clínicas. Resultados. El promedio de edad fue de 31 años, sexo femenino 86.4%, la media de años de experiencia en el servicio fue de 1.54 años. El porcentaje de respuestas correctas de conocimientos fue de 30.7% para enfermeras profesionales y 25.6% para auxiliares. Discusión. Aunque se han realizado a nivel internacional estudios que han evaluado el conocimiento y actitudes del dolor haciendo uso del mismo cuestionario, este estudio es el primero en Colombia que compara enfermeras y auxiliares, evidenciando mejores porcentajes de respuestas correctas y mayor número de preguntas con resultados clasificados como “satisfactorios”. Conclusiones. El nivel de conocimientos y actitudes respecto al dolor obtenidos de las enfermeras es mayor que en los auxiliares; sin embargo, se identificaron en ambas poblaciones debilidades específicas en estas áreas. Palabras clave: Conocimiento; Dolor; Enfermería; Manejo del Dolor; Dimensión del Dolor. ABSTRACT Introduction. Pain is defined by the International Association for the Study of Pain (IASP) as an unpleasant sensory and emotional experience. Therefore, the role of nursing in this fifth vital constant is fundamental. The objective of this study was to describe the level of knowledge and attitudes of professional nurses and nursing assistants regarding pain in a tertiary health care institution in Bucaramanga, Colombia. Methodology. A descriptive cross-sectional study, with a sample of 162 participants. The Knowledge and Attitudes Survey Regarding Pain was used. Inclusion criteria: Professional nurses and assistants with at least three months in service. Exclusion criteria: Nursing students and nurses with formative and non-missional tasks. Results. The average age was 31 years, 86.4% female, and the average number of years of experience in service was 1.54 years. The percentage of correct answers in knowledge was 30.7% for professional nurses and 25.6% for assistants. Discussion. Although some international studies have evaluated knowledge and attitudes regarding pain using the same survey, this study is the first in Colombia that compares nurses and assistants, showing better percentages of correct answers and a greater number of questions with results classified as “satisfactory.” Conclusions. The level of knowledge and attitudes regarding pain obtained from the nurses is higher than that of assistants. However, specific weaknesses in these areas were identified in both populations. Keywords: Knowledge; Pain; Nursing; Pain Management; Pain Measurement. RESUMO Introdução. A dor é definida pela Associação Internacional para o Estudo da Dor (IASP, sigla em inglês) como uma experiencia sensorial e emocional desagradável. Portanto, o papel que a enfermagem desempenha neste quinto sinal vital é fundamental. O objetivo deste estudo foi descrever o nível de conhecimento e atitudes de enfermeiras e auxiliares em relação à dor em uma instituição de atendimento terciário de Bucaramanga, Colômbia. Metodologia. Estudo descritivo, transversal, com uma amostra de 162 participantes. Foi utilizado o questionário Knowledge and Attitudes Survey Regarding Pain. Critérios de inclusão: enfermeiras e auxiliares com no mínimo três meses no serviço. Critérios de exclusão: estudantes de enfermagem e enfermeiras com funções de formação e não missionárias. Resultados. A idade média foi de 31 anos, sexo feminino 86,4%, a média de anos de experiência no serviço foi de 1,54 anos. O percentual de respostas corretas de conhecimento foi de 30,7% para enfermeiras e 25,6% para auxiliares. Discussão. Embora tenham sido realizados estudos internacionais que avaliaram conhecimentos e atitudes sobre a dor usando o mesmo questionário, este estudo é o primeiro na Colômbia que compara enfermeiras e auxiliares, mostrando melhores percentuais de respostas corretas e maior número de perguntas com resultados classificados como “satisfatórios”. Conclusões. O nível de conhecimento e atitudes em relação à dor, obtido das enfermeiras é superior ao dos auxiliares. No entanto, foram identificadas fragilidades específicas nestas áreas em ambas as populações. Palavras-chave: Conhecimento; Dor; Enfermagem; Manejo da Dor; Medição da Dor.

Objective: To evaluate the focus of pediatricians’ gaze during the heel prick of neonates. Methods: Prospective study in which pediatricians wearing eye tracker glasses evaluated neonatal pain before/after a heel prtick. Pediatricians scored the pain they perceived in the neonate in a verbal analogue numerical scale (0=no pain; 10=maximum pain). The outcomes measured were number and time of visual fixations in upper face, lower face, and hands, in two 10-second periods, before (pre) and after the puncture (post). These outcomes were compared between the periods, and according to pediatricians’ pain perception: absent/mild (score: 0–5) and moderate/intense (score: 6–10). Results: 24 pediatricians (31 years old, 92% female) evaluated 24 neonates. The median score attributed to neonatal pain during the heel prick was 7.0 (Interquartile range: 5–8). Compared to pre-, in the post-periods, more pediatricians fixed their gaze on the lower face (63 vs. 92%; p=0.036) and the number of visual fixations was greater on the lower face (2.0 vs. 5.0; p=0.018). There was no difference in the number and time of visual fixations according to the intensity of pain. Conclusions: At bedside, pediatricians change their focus of attention on the neonatal face after a painful procedure, focusing mainly on the lower part of the face. [ABSTRACT FROM AUTHOR]

Background Although there are several ways to assess pain in dementia, there is still a need for tools with better items to assess the presence of pain intensity in these individuals.

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Introduction: Since infants are not able to express their feelings during the preverbal stage of development, neonatal pain rating scales are good tools for nurses to use in clinical practice. Objective: To describe valid and reliable scales used in nursing practice to assess neonatal pain. Materials and Methods: An integrative review of articles published since 1990 was conducted from 2019 to 2020. The databases consulted were PubMed, Lilacs, ProQuest, ScienceDirect, Embase, VHL, Scopus, and Google Scholar metasearch engine. Twenty-two articles that met the inclusion criteria were analyzed. Results: Unidimensional and multidimensional instruments were found for assessing acute and prolonged pain in preterm and term neonates. Discussion: This integrative review provides healthcare professionals, especially nurses, with a conceptual basis for implementing clinical pain assessment tools according to gestational age, duration of pain, and type of indicator. Conclusions: According to the knowledge and characteristics of the scales, it is not possible to clearly establish the most appropriate one for general use or a gold standard; the selection will depend on different criteria, such as the type of stimulus, gestational age, and the newborn's context. [ABSTRACT FROM AUTHOR]

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RESUMO Objetivo: Avaliar a intensidade de dor durante a punção arterial realizada em recém-nascidos internados em uma unidade de cuidados progressivos neonatais e avaliar a percepção do profissional em relação à dor neonatal. Métodos: Estudo observacional analítico, em que foram observadas 62 punções arteriais realizadas em 35 neonatos. Avaliou-se a dor durante a coleta pela escala Premature Infant Pain Profile. Os profissionais responsáveis pela coleta avaliaram a dor pela escala numérica verbal de zero a dez. Os dados foram submetidos à análise estatística descritiva por meio do programa Statistical Package for the Social Science. Resultados: Entre os recém-nascidos, 30,6% (n = 19) não tiveram dor ou tiveram dor leve (0 - 6), 24,2% (n = 15) apresentaram dor leve a moderada (7 - 11) e 45,2% (28) dor intensa (12 - 21). Constatou-se que os profissionais identificam a dor durante o procedimento. Conclusão: A punção arterial é considerada um procedimento doloroso e pode resultar em dor leve a intensa, sendo necessária a adoção de estratégias sistematizadas de avaliação, possibilitando a intervenção terapêutica adequada.

Introdução: A dor constitui-se como o principal motivo de procura de cuidados de saúde no serviço de urgência. Os enfermeiros têm um papel essencial na promoção e intervenção no controlo da dor dado serem profissionais com uma relação privilegiada com as pessoas. Objetivo: Descrever como foi avaliada e registada a dor na área de ambulatório de um serviço de urgência geral pela equipa de enfermagem. Metodologia: Estudo quantitativo, descritivo e transversal. Foram analisados os registos de avaliação da dor de 105 pessoas. Procedeu-se à análise dos dados utilizando estatística descritiva. Resultados: A dor foi avaliada em 53 episódios (50,48 %). A Escala de Avaliação Numérica foi o instrumento mais utilizado (43,81 %). As características da dor foram descritas em 39,05 % dos episódios. Em 1,90 % dos episódios houve registo de reavaliação da dor após implementação de medidas farmacológicas. Conclusão: A avaliação da dor foi subnotificada nas diferentes dimensões descritas no estudo. Neste sentido, torna-se essencial a definição de estratégias para a formação e treino dos enfermeiros sobre avaliação da dor.

Platelet-rich plasma (PRP) has been shown to be a promising treatment for osteoarthritis (OA) of the knee in adult and elderly patients, acting in the repair of joint tissues damaged by OA - a degenerative disease that mainly affects articular cartilage. This process of degradation of joint components leads to an increase in the level of pain in these patients. Therefore, this study aimed to evaluate the effectiveness of intra-articular injection of PRP in knee OA in relation to pain. For this systematic review, five databases were used: PubMed, Lilacs, PEDro, Cochrane Library and Google Scholar. Search strategies included the keywords Osteoarthritis, Knee, Platelet-rich plasma, and Pain. In order to be included in this review, the studies had to be of the randomized clinical trial type; use as a sample people between 18 and 80 years old diagnosed with knee OA; use intra-articular PRP treatment compared to placebo; and assess pain intensity. After completion of the selection phase, 5 studies were included in this review. These showed positive results in reducing pain in patients with lower-degeneration OA, and less effective in advanced OA. Furthermore, few side effects were reported after the application of PRP. Therefore, the intra-articular application of PRP can be an important tool for the treatment of knee OA, as it is an effective therapy in decreasing pain levels in patients affected by this pathology. [ABSTRACT FROM AUTHOR]

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Objetivo: Avaliar a presença da dor em indivíduos com acidente vascular cerebral (AVC) e sua relação com o desempenho funcional e a qualidade de vida (QV). Métodos: Estudo transversal onde 50 indivíduos com AVC atendidos em um centro de reabilitação foram avaliados por meio da Escala Visual Numérica (EVN), Questionário de Dor McGill, SF-36 e Índice de Barthel (IB). A estatística inferencial foi realizada por meio do Teste T e do coeficiente de correlação de Pearson. Resultados: A presença de dor foi verificada em 64% da população, com média sete na EVN e expressivo número e intensidade de descritores do McGill. Os pacientes com dor apresentaram piores escores para QV nos domínios saúde mental (p = 0,046), estado geral da saúde (p = 0,021), aspectos emocionais (p = 0,034) e dor (p < 0,0001). A dor no hemicorpo hígido estava presente em 37% dos pacientes. A EVN correlacionou-se com o estado geral da saúde da SF-36 (r = -0,359; p = 0,043); já o McGill com a saúde mental (r = -0,364; p = 0,041), capacidade funcional (r = -0,365; p = 0,039) e aspectos emocionais (r = -0,374; p = 0,035). Não houve relação entre a dor e o IB. Conclusões: Este estudo mostrou alta incidência e intensidade de dor em indivíduos com AVC, mesmo em reabilitação. A presença da dor interferiu mais na QV do que na função e o McGill relacionou-se com mais domínios da SF-36 do que a EVN.

RESUMO Objetivo: Avaliar temporalmente o estímulo doloroso em prematuros com o uso de três escalas de mensuração de dor neonatal. Métodos: Foram observados 83 prematuros durante a aspiração de vias aéreas por três avaliadores (E1, E2 e E3) utilizando três escalas de avaliação da dor (Neonatal Facial Coding System - NFCS; Neonatal Infant Pain Scale - NIPS; e Premature Infant Pain Profile - PIPP) em cinco momentos: T1 (antes da aspiração de vias aéreas), T2 (durante a aspiração de vias aéreas), T3 (1 minuto após a aspiração de vias aéreas), T4 (3 minutos após a aspiração de vias aéreas) e T5 (5 minutos após a aspiração de vias aéreas). Utilizaram-se o Light’s Kappa (concordância entre examinadores e entre as escalas em cada tempo) e teste de McNemar (comparação entre os tempos), considerando-se p < 0,05. Resultados: Houve diferença significativa entre T1 e T2 para os três examinadores nas três escalas. Em T3, observou-se dor em 22,9%/E1, 28,9%/E2 e 24,1%/E3 de acordo com a NFCS; 22,9%/E1, 21,7%/E2 e 16,9%/E3, conforme a NIPS e 49,4%/E1, 53,9%/E2 e 47%/E3 considerando a PIPP dos prematuros. Houve diferença entre T1 e T3 nas três escalas, exceto para dois examinadores na PIPP (E2: p = 0,15/ E3: p = 0,17). Ao comparar T4 e T5 ao T1, não houve diferença em nenhuma das três escalas. Conclusão: Os prematuros necessitaram de pelo menos 3 minutos para retornarem ao seu estado inicial de repouso (sem dor).

RESUMO Objetivo: Descrever a adequação de duas escalas comportamentais, a Behavioral Pain Scale e a Critical Care Pain Observation Tool, para a avaliação da dor em pacientes intubados orotraquealmente, internados em unidades de terapia intensiva. Método: Utilizando a metodologia recomendada pelo Centro Cochrane, foi realizada revisão sistemática da literatura, na base de dados eletrônica EBSCO host (CINAHL Complete, MEDLINE®Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina). Foram realizadas duas pesquisas com os seguintes termos em inglês no campo de pesquisa: "behavioral pain scale" AND "critical care pain observation tool" AND "behavioral pain scale" OR "critical care pain observation tool". Dois revisores independentes realizaram a avaliação crítica, a extração e a síntese dos dados. Resultados: Foram incluídos 15 estudos que evidenciaram que a Behavioral Pain Scale e a Critical Care Pain Observation Tool eram duas escalas válidas e confiáveis para a avaliação da dor em pacientes intubados orotraquealmente e internados em unidade de terapia intensiva. As escalas apresentaram propriedades psicométricas semelhantes, bem como boa confiabilidade. Conclusão: Ambas as escalas são adequadas para a avaliação da dor em pacientes intubados orotraquealmente, internados em unidade de terapia intensiva, contudo, apresentam limitações em populações específicas como doentes vítimas de trauma, queimados e do foro neurocirurgico. É sugerida a realização de mais estudos sobre o tema e em populações específicas.

Objective: To evaluate pain intensity during arterial puncture performed in newborns admitted to a neonatal progressive care unit and to evaluate the perception of health professionals regarding neonatal pain. Methods: This was an observational analytical study in which 62 arterial punctures were performed in 35 neonates. Pain was assessed during collection using the Premature Infant Pain Profile scale. The health professionals responsible for collection evaluated pain using a verbal numerical scale ranging from zero to ten. The data were subjected to descriptive statistical analysis using the Statistical Package for the Social Science software. Results: Among the newborns, 30.6% (n = 19) had no pain or mild pain (0 - 6), 24.2% (n = 15) had mild to moderate pain (7 - 11) and 45.2% (28) had severe pain (12 - 21). It was found that health professionals identified pain during the procedure. Conclusion: Arterial puncture is considered a painful procedure that can result in mild to severe pain. The adoption of systematic evaluation strategies is necessary to enable appropriate therapeutic intervention. [ABSTRACT FROM AUTHOR]

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Objective: to understand the complexity of the assessment and management of chronic oncologic pain in hospitalized children. Method: qualitative study based on Complexity Theory and Grounded Theory. A total of 21 health professionals participated in the research. Semi-structured interview and non-participant observation were used to collect the data. The analysis followed the coding steps. Result: the pain assessment performed by professionals is based on the relative’s report, the child’s report and the observation of the child’s behavior. Analog color scale, face scale and numerical scale were used. Pharmacological analgesia is the medical prescription; and, in non-pharmacological, ludic aspects, conversation, massage, bathing, warm or cold compress and comfort promotion are performed. Conclusion: the assessment and management process of chronic oncologic pain in hospitalized children requires that health professionals have technical and scientific preparation to deal with objective and subjective aspects that involve this care.

Objective: to understand the complexity of the assessment and management of chronic oncologic pain in hospitalized children. Method: qualitative study based on Complexity Theory and Grounded Theory. A total of 21 health professionals participated in the research. Semi-structured interview and non-participant observation were used to collect the data. The analysis followed the coding steps. Result: the pain assessment performed by professionals is based on the relative's report, the child's report and the observation of the child's behavior. Analog color scale, face scale and numerical scale were used. Pharmacological analgesia is the medical prescription; and, in non-pharmacological, ludic aspects, conversation, massage, bathing, warm or cold compress and comfort promotion are performed. Conclusion: the assessment and management process of chronic oncologic pain in hospitalized children requires that health professionals have technical and scientific preparation to deal with objective and subjective aspects that involve this care. [ABSTRACT FROM AUTHOR]

Objective: To compare and assess the immediate analgesic effects of conventional and burst transcutaneous electrical nerve stimulation in patients with chronic low back pain. Methods: We conducted a three-arm single-blinded randomized controlled trial. A total of 105 patients with non-specific chronic low back pain aged between 18 and 85 years were randomly assigned into the following groups: Placebo Group (sham electrical stimulation), Conventional TENS Group (continuous stimulation at 100Hz for 100µs with sensory intensity), and Burst TENS Group (stimulation at 100Hz modulated at 2Hz for 100µs with motor-level intensity). All groups received a single application of transcutaneous electrical nerve stimulation for 30 minutes. The outcomes, namely, pain intensity, quality of pain, and pressure pain threshold were measured by the visual analog scale, McGill pain questionnaire, and algometry, respectively. The patients were evaluated before and immediately after the transcutaneous electrical nerve stimulation application. Results: Pain intensity (visual analog scale score) and quality of pain (McGill pain questionnaire score) significantly decreased (p<0.05) in Intervention Groups (Conventional TENS Group and Burst TENS Group). A positive effect was observed in the interventions compared to the Placebo Group in all domains of the McGill pain questionnaire (p<0.05), excepting for the pain intensity. Pressure pain threshold significantly increased (p<0.05) immediately after the transcutaneous electrical nerve stimulation application in both Intervention Groups, but not in the Placebo Group. For significant difference was found during assessment when comparing both Intervetion Group. Conclusion: Both transcutaneous electrical nerve stimulation modes were effective for pain modulation. Moreover, there was an increase in the pressure pain threshold. No significant results were found to indicate the best mode for the treatment of chronic low back pain. [ABSTRACT FROM AUTHOR]

Aim: to analyze nursing practice concerning pain assessment of newborns admitted to a Neonatal Intensive Care Unit (NICU). Methods: descriptive study in a qualitative approach, developed with 22 nursing professionals at a Neonatal Intensive Care Unit in Rio de Janeiro, Brazil. It was used a semi-structured interview and data was submitted to a Content Analysis. Results: the majority of the interviewees were women, aged between 34-55 years, with levels of schooling as undergraduate and specialization/post graduation. The following categories emerged: Pain identification; The Systematization of Nursing Care due to pain management; and Pharmacological and non-Pharmacological use in the control pain. It was verified that the Nursing Team assumes that Newborns feel pain, identifies pain by physiological and behavioral parameters, applies some non-pharmacological measures for its control, but does not use pain assessment scales, resulting in sub-treatment. Conclusions: pain assessment is not strengthened in nursing practice, and there is a necessity of knowledge update about the implementation of a pain evaluation scale aiming quality of care.

RESUMO A terapia a laser de baixa intensidade (LLLT) vem sendo amplamente discutida na literatura como forma alternativa de tratamento para diversos tipos de dor, com destaque para a neuropática. Essa terapia sobressai pelo fato de não ser invasiva, raramente causar efeitos colaterais e ser de baixo custo. Em contrapartida, para sua eficácia, é necessário o detalhamento dos parâmetros, que ainda são muito discrepantes na literatura. Assim, este trabalho tem como objetivo investigar o efeito da LLLT, na faixa do infravermelho, com fluência de 30J/cm², no controle da dor neuropática em modelo animal. Foram utilizados 24 camundongos da cepa suíço albino, machos, pesando 2530 gramas, divididos em três grupos: Grupo Placebo (GP), Grupo Laser (GL30) e Grupo Sham (GS). A indução da neuropatia foi feita através do modelo de constrição crônica do nervo isquiático (CCI), e o tratamento da LLLT realizou-se da seguinte maneira: GP com o laser com fluência de 0J/cm2, GL30 tratado com fluência de 30J/cm2, e GS com simulação de cirurgia sem intervenção. Executaram-se as irradiações 3 vezes por semana, durante 90 dias, no ponto de compressão do nervo, utilizando-se a técnica de contato. A fins de avaliação, foram utilizados o teste da placa quente, para hiperalgesia térmica, e o Teste de Randall-Selitto para hiperalgesia mecânica. Nos resultados do GP, observamos que não houve melhora significativa nos dias após a cirurgia em nenhum dos testes realizados e, no GL30, observou-se uma melhora expressiva em ambos os testes a partir do 30º dia de tratamento para o teste de Placa Quente e a partir do 45º para o Randall-Selitto, em que os camundongos apresentaram restauração total da sensibilidade. Concluímos, pois, que a utilização de LLLT com fluência de 30J/cm2 no tratamento da dor neuropática em modelo animal é eficaz.

Background: Currently, different pain scales are used extensively to measure clinical pain, especially in dental practice. Objective: This study aims to compare pain scales used in clinical research and dental practice, identifying the easiest to understand by patients with Cervical Dentin Hypersensitivity. Method: Seventy-four patients with Cervical Dentin Hypersensitivity were stimulated by a thermic test of the sensitive tooth, followed by application of different pain measurement scales (Visual Analogue Scale, Faces Pain Scales, Numeric Rating Scale, and Verbal Rating Scale) and by a questionnaire to evaluate the patient's perception regarding the ease of understanding scales. The statistic tests used were the Wilcoxon, Spearman correlation, and Chi-Square tests. Results: The results founded a strong positive correlation between the scales (r = 0.798 to 0.960 p <0.001). The was easiest scale to understand according to the patients was the Verbal Rating Scale (52.7%). Conclusion: The pain measurement scales evaluated provide similar information about pain reported in the Cervical Dentin Hypersensitivity allowing the comparison between studies that used them to measure pain. The affinity of the patient with the pain scale can guide the clinical dental practice in the different levels of health care. [ABSTRACT FROM AUTHOR]

Objective: To temporally assess a painful stimulus in premature infants using 3 neonatal pain scales. Methods: A total of 83 premature infants were observed during airway aspiration by 3 evaluators (E1, E2 and E3) using 3 pain assessment scales (Neonatal Facial Coding System - NFCS; Neonatal Infant Pain Scale - NIPS; and Premature Infant Pain Profile - PIPP) at 5 time points: T1 (before airway aspiration), T2 (during airway aspiration), T3 (1 minute after airway aspiration), T4 (3 minutes after airway aspiration), and T5 (5 minutes after airway aspiration). Light's Kappa (agreement among examiners and among scales at each time point) and the McNemar test (comparison among time points) were used considering p < 0.05. Results: There was a significant difference between the 3 examiners for T1 and T2 using the 3 scales. In T3, pain was observed in 22.9%/E1, 28.9%/E2, and 24.1%/E3 according to the NFCS; 22.9%/E1, 21.7%/E2, and 16.9%/E3 according to the NIPS; and 49.4%/E1, 53.9%/E2, and 47%/ E3 according to the PIPP. There was a difference between T1 and T3 using the 3 scales, except for 2 examiners for the PIPP (E2: p = 0.15/E3: p = 0.17). Comparing T4 and T5 to T1, there was no difference in the 3 scales. Conclusion: Premature infants required at least 3 minutes to return to their initial state of rest (no pain). [ABSTRACT FROM AUTHOR]

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Objective: to assess analgesia effectiveness and agreement between the Numerical and Faces scales in trauma patients in the emergency department. Method: a cross-sectional study with 173 patients performed from February 2013 to September 2014. Pain was assessed on admission and one hour after analgesia by using the Numerical and Faces scales. To compare pain before and after analgesia, the Spearman Correlation Coefficient was used and. To analyze agreement between the scales, Kappa Index was used. Results: on admission, most patients reported moderate and severe pain. There was pain relief, but 36.0% of patients remained with mild pain and 33.7% moderate pain, requiring analgesic supplementation. Agreement between the scales was considerable before analgesia (Kappa = 0.31, p-value

Introdução: A Artroplastia Total de Quadril se apresenta como um procedimento eficaz para a diminuição da dor em articulações e para a melhora funcional das pessoas. Objetivo: Selecionar resultados e indicadores da Nursing Outcomes Classification (NOC) e construir definições conceituais e operacionais, para avaliação da dor de pacientes após Artroplastia Total de Quadril. Materiais e Métodos: Estudo de consenso entre especialistas. As definições foram construídas baseadas na literatura e experiência dos autores. Estabeleceu-se um consenso de 100% para o conteúdo do instrumento das definições conceituais e operacionais do resultado de enfermagem. Resultados: Foi selecionado o resultado de enfermagem Nível de dor, com onze indicadores, a mencionar: Dor relatada, Duração dos episódios de dor, Expressões faciais de dor, Agitação, Irritabilidade, Encolhimento, Diaforese, Náusea, Frequência respiratória, Frequência do pulso radial e Pressão arterial. Cada um dos onze indicadores foi definido conceitual e operacionalmente. Discussão e Conclusões: A seleção desse resultado e de seus indicadores, assim como a construção das definições podem favorecer a aplicação da NOC com maior fidedignidade nessa população, além de aprimorar a assistência e contribuir no aperfeiçoamento da classificação. Como citar este artículo: Rodríguez-Acelas AL, Cañon-Montañez W, Mantovani VM, Figueiredo MS, Silva MB, Almeida MA. Resultado de enfermagem para avaliação da dor após artroplastia de quadril. Rev Cuid. 2019; 10(2): e651. http://dx.doi.org/10.15649/cuidarte.v10i2.651

ABSTRACT Objectives: to correlate risk classification categories with the level of pain of patients in an emergency service. Method: cross-sectional study carried out in the Risk Classification of 611 patients. The variables studied were: age, gender, comorbidities, complaint duration, medical specialty, signs and symptoms, outcome, color attributed in the risk classification of and degree of pain. We used Analysis of Variance, a Chi-Square test and a Likelihood Ratio test. Results: the average age was 42.1 years (17.8); 59.9% were women; the green (58.9%) and yellow (22.7%) risk classification prevailed and hypertension (18.3%) was the most common Comorbidity. The most frequent pain intensity was moderate (25.9%). In the red category, patients presented a higher percentage of absence of pain; in the blue, mild pain; and in the green, yellow and orange categories, there was a greater percentage of intense pain (p < 0.0001). Conclusion: among the patients who presented pain, the majority reported moderate intensity. Regarding risk categories, most patients in the red category did not report pain. Those who were classified as green, yellow and orange, reported mostly intense pain. On the other hand, patients in the blue category reported predominantly mild pain.

Objective: To describe the appropriateness of two behavioral scales, the Behavioral Pain Scale and the Critical Care Pain Observation Tool, for pain assessment in orotracheally intubated patients admitted to intensive care units. Method: Using the methodology recommended by the Cochrane Center, a systematic literature review was performed in the electronic database EBSCO Host (CINAHL Complete; MEDLINE® Complete; Nursing & Allied Health Collection: Comprehensive; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; Cochrane Methodology Register; Library, Information Science & Technology Abstracts; MedicLatina). Two searches were conducted using the following English terms in the search field: “behavioral pain scale” AND “critical care pain observation tool” AND “behavioral pain scale” OR “critical care pain observation tool”. Two independent reviewers performed the critical evaluation and data extraction and synthesis. Results: Fifteen studies were included that showed that the Behavioral Pain Scale and the Critical Care Pain Observation Tool are valid and reliable scales for pain assessment in orotracheally intubated patients admitted to the intensive care unit. The scales showed similar psychometric properties and good reliability. Conclusion: Both scales are adequate for assessing pain in orotracheally intubated patients admitted to intensive care units; however, they exhibit limitations in specific populations, such as trauma, burn and neurosurgical patients. Further studies on the subject and in specific populations are suggested. [ABSTRACT FROM AUTHOR]

Objective: To propose and analyze the test-retest reliability of an instrument to verify the presence and intensity of pain in the cervical, thoracic and lumbar spine in Brazilian young people. Methods: This reliability study enrolled a sample of 458 participants (13 to 20 years). Two groups were formed for each sex according to the range of days for the test-retest (10±3 and 28±2 days). For analysis of spinal pain, a drawing of the human body with cervical, thoracic and lumbar spine areas delimited was presented. The following question was presented: during a normal day, do you feel pain in any of these regions of your spine? If so, what is the intensity from 0 to 10 (mark on the line)? The starting point, with the number 0, corresponded to no pain, and the number 10 to severe pain. The agreement of frequency and of intensity of pain was verified by Kappa test and Bland-Altman plot, respectively. Results: Intraclass correlation coefficients ranged from 0.71 (confidence interval of 95% — 95%CI — 0.59–0.79) to 0.94 (95%CI 0.90–0.96). The results concerning the agreement of pain scores showed the mean differences to be close to 0, and the largest mean difference was -0.40 (95%CI -5.14–4.34). The agreement in reported pain ranged from 72.2 (Kappa 0.43; 95%CI 0.28–0.58) to 90.1% (Kappa 0.76; 95%CI 0.60–0.92). Conclusions: This instrument was shown to be a reliable manner to verify the pain in different regions of the spine in Brazilian young people. [ABSTRACT FROM AUTHOR]

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Dysmenorrhea is described as pain or weight in the hypogastrium and can radiate to the lumbar region or to the thighs. The use of the vector interferential current (CIV) is based on two sinusoidal currents of medium frequency, modulated at low frequency, and can reach deep tissues in a pleasant way. Despite widespread use of this current under various conditions, there are few studies on its use in primary dysmenorrhea associated with low back pain. The aim of this study was to evaluate the analgesic effect of the Tetrapolar Interferential Current on primary dysmenorrhea associated with low back pain. The study consisted of 20 volunteers, divided into 2 groups: Placebo Group (GP) and Group Treatment (GT), with treatment for 3 days in two menstrual cycles. The variables analyzed were the McGill Pain Questionnaire at the beginning of the first intervention and on the last day after the procedure, and the Visual Analog Pain Scale, applied before and after each therapy. It was observed that for the McGill questionnaire there was reduction only for the treated group, for the Pain scale there were differences again between groups and between evaluations, and the size of the effect showed favorable results in the treated group. The interferential current in the quadrilateral form was shown to be effective in reducing pain in young patients with primary dysmenorrhea. [ABSTRACT FROM AUTHOR]

Introduction: Total Hip Arthroplasty (THA) is an effective procedure to relieve joint pain and to provide functional improvement in patients. Objective: Based on the outcomes and indicators from the Nursing Outcomes Classification (NOC), this study aims to create conceptual and operational definitions to assess pain in patients undergoing Total Hip Arthroplasty. Materials and Methods: Consensus study among experts. Definitions were based on literature review and author experience. Complete agreement was found on instrument content in relation to the conceptual and operational definitions from nursing outcomes. Results: The nursing outcome 'pain level' was selected which had eleven indicators, being notable the self-reported pain, duration of pain episodes, facial expressions of pain, agitation, irritability, muscle contraction, diaphoresis, nausea, respiratory rate, heart rate at the radial point and blood pressure. Discussion and conclusions: The selection of this outcome and its indicators as well as the creation of definitions might benefit the NOC application in a more reliable manner over that population, apart from improving assistance and helping adjust this classification. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: to assess analgesia effectiveness and agreement between the Numerical and Faces scales in trauma patients in the emergency department. Method: a cross-sectional study with 173 patients performed from February 2013 to September 2014. Pain was assessed on admission and one hour after analgesia by using the Numerical and Faces scales. To compare pain before and after analgesia, the Spearman Correlation Coefficient was used and. To analyze agreement between the scales, Kappa Index was used. Results: on admission, most patients reported moderate and severe pain. There was pain relief, but 36.0% of patients remained with mild pain and 33.7% moderate pain, requiring analgesic supplementation. Agreement between the scales was considerable before analgesia (Kappa = 0.31, p-value <0.0001) and moderate after (Kappa = 0.56, p-value <0.0001). Conclusion: the majority of patients obtained pain relief after analgesia, and there was agreement between the scales. [ABSTRACT FROM AUTHOR]

Objective: To assess the Perme mobility scale score as a predictor of functional status and complications in the postoperative period in patients undergoing liver transplantation. Methods: The sample consisted of 30 patients who underwent liver transplantation. The patients were evaluated at two time points to determine their perception of pain, degree of dyspnea, peripheral muscle strength, and functional status according to the Perme scale. The collected data were analyzed by descriptive and inferential statistics. To compare the means between the evaluations, Student's t test for paired samples was applied. In case of asymmetry, the Wilcoxon test was used. In the evaluation of the association between the quantitative variables, the Pearson or Spearman correlation tests were applied. Results: A total of 30 individuals who underwent liver transplantation were included. The patients were predominantly male, and the mean age was 58.4 ± 9.9 years. The most prevalent underlying pathology was cirrhosis C virus (23.3%). Significant associations of the time on mechanical ventilation with the Perme scale score at discharge from the intensive care unit (r = -0.374; p = 0.042) and the number of physical therapy treatments (r = -0.578; p = 0.001) were recorded. When comparing the results of the initial evaluation and the evaluation at hospital discharge, there was a significant improvement in functional status (p < 0.001). Conclusion: Functional mobility, peripheral muscle strength, pain perception, and dyspnea are significantly improved at hospital discharge compared with those at inpatient unit admission. [ABSTRACT FROM AUTHOR]

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Resumo Objetivo Descrever a frequência, características, localização, intensidade da dor em pacientes com câncer de mama em uso do quimioterápico Docetaxel. Métodos Estudo longitudinal realizado com 17 mulheres com câncer de mama em tratamento com Docetaxel. As pacientes foram avaliadas durante três ciclos da quimioterapia quanto à dor, utilizando-se os instrumentos Questionário McGill de Dor (Br-MPQ) e Brief Pain Inventory (BPI). Utilizou-se a correlação de Spearman e o teste de Mann-Whitney. Resultados Houve aumento na média da dor em todas as variáveis do BPI. Quando comparados os valores do Pain Rating Index (PRI) total foram verificados respectivamente 0,20; 0,33 e 0,24 na primeira, segunda e terceira avaliações, sendo encontrada correlação entre a intensidade da dor e a interferência em todas as atividades do cotidiano no BPI na segunda avaliação. Conclusão Houve aumento na ocorrência da dor, comprometendo as atividades diárias de vida das mulheres participantes.

RESUMO Objetivo: verificar a presença e severidade de Disfunção Temporomandibular, presença de cefaleia e cervicalgia e o limiar de dor muscular de músculos cervicais em profissionais de enfermagem sob estresse no trabalho. Métodos: 43 mulheres foram avaliadas quanto à presença e severidade de Disfunção Temporomandibular pelo instrumento Critérios de Diagnóstico para Pesquisa de Desordem Temporomandibular e pelo Índice Temporomandibular, respectivamente. Além disso, foram avaliadas quanto ao limiar de dor à pressão nos músculos cervicais por algometria e quanto à presença de cefaleia e cervicalgia. Resultados: disfunção Temporomandibular foi encontrada em 30,23% da amostra, com valor médio de escore de gravidade de 0,52. Entre as participantes com Disfunção Temporomandibular, 69,23% apresentavam depressão, 61,64% graduação I de dor crônica e Sintomas Físicos não Específicos incluindo e excluindo itens de dor em 46,15% e 61,64%, respectivamente. Cefaleia foi referida por 55,81% e cervicalgia por 60,47%. Não houve associação entre Disfunção Temporomandibular, cefaleia e cervicalgia. Os limiares de dor dos músculos cervicais apresentaram-se baixos tanto nos indivíduos com diagnóstico de Disfunção Temporomandibular quanto nos sem este diagnóstico, sem diferença significativa. O músculo esternocleidomastóideo apresentou-se com os menores limiares de dor à pressão. Conclusão: alta incidência de Disfunção Temporomandibular, cefaleia e cervicalgia foram detectadas nesta amostra. Disfunção Temporomandibular não influenciou a presença de cefaleia e/ou cervicalgia. A alta frequência de dor cervical e os baixos limiares de dor no músculo esternocleidomastóideo em todas as participantes demonstram o comprometimento dos músculos cervicais, resultante de possíveis posturas inadequadas e tensão muscular relacionadas ao estresse.

RESUMO Objetivo: Avaliar a dor e observar parâmetros fisiológicos em crianças sedadas e submetidas à ventilação mecânica durante um procedimento de rotina. Métodos: Estudo observacional realizado em uma unidade de terapia intensiva pediátrica. Foram avaliadas 35 crianças, com idades entre 1 mês e 12 anos, em três momentos distintos: antes, durante e 5 minutos após coleta de sangue arterial para análise gasométrica (procedimento doloroso). Utilizou-se a Escala Face, Legs, Activity, Cry and Consolability para avaliação da dor e foram registradas a frequência cardíaca, frequência respiratória, saturação periférica de oxigênio e pressão arterial (sistólica e diastólica). O nível de sedação dos participantes foi verificado utilizando-se a escala Comfort-B, aplicada antes da mensuração da dor e da avaliação dos parâmetros fisiológicos. Resultados: Durante os estímulos dolorosos, ocorreu aumento do escore da Escala Face, Legs, Activity, Cry and Consolability (p = 0,0001). Houve também aumento da frequência cardíaca (p = 0,03), da frequência respiratória (p = 0,001) e da pressão arterial diastólica (p = 0,006) em razão da dor causada pelo procedimento de rotina. Conclusões: Avaliação da dor com uso de escalas padrão, como a Escala Face, Legs, Activity, Cry and Consolability, e observação de parâmetros fisiológicos, deve ser realizada rotineiramente para melhorar o manejo da dor nas unidades de terapia intensiva pediátricas.

ABSTRACT OBJECTIVE: To compare the use of analgesia versus neonatologists' perception regarding analgesic use in painful procedures in the years 2001, 2006, and 2011. METHODS: This was a prospective cohort study of all newborns admitted to four university neonatal intensive care units during one month in 2001, 2006, and 2011. The frequency of analgesic prescription for painful procedures was evaluated. Of the 202 neonatologists, 188 answered a questionnaire giving their opinion on the intensity of pain during lumbar puncture, tracheal intubation, mechanical ventilation, and postoperative period using a 10-cm visual analogic scale (VAS; pain >3 cm). RESULTS: For lumbar puncture, 12% (2001), 43% (2006), and 36% (2011) were performed using analgesia. Among the neonatologists, 40-50% reported VAS >3 for lumbar puncture in all study periods. For intubation, 30% received analgesia in the study periods, and 35% (2001), 55% (2006), and 73% (2011) of the neonatologists reported VAS >3 and would prescribe analgesia for this procedure. As for mechanical ventilation, 45% (2001), 64% (2006), and 48% (2011) of patient-days were under analgesia; 56% (2001), 57% (2006), and 26% (2011) of neonatologists reported VAS >3 and said they would use analgesia during mechanical ventilation. For the first three post-operative days, 37% (2001), 78% (2006), and 89% (2011) of the patients received analgesia and more than 90% of neonatologists reported VAS >3 for major surgeries. CONCLUSIONS: Despite an increase in the medical perception of neonatal pain and in analgesic use during painful procedures, the gap between clinical practice and neonatologist perception of analgesia need did not change during the ten-year period.

A dor é um sintoma universal em Medicina e, na Dermatovenereologia, é transversal ao domínio médico e cirúrgico da especialidade. O controlo da dor aguda peri-operatória é um indicador de qualidade dos cuidados de saúde, sendo um fator determinante de morbilidade e de satisfação do doente. O tratamento pouco eficaz da dor crónica tem repercussões significativas na qualidade de vida e a nível socioeconómico. Esta revisão contempla os princípios gerais do tratamento da dor aguda peri-operatória e da dor crónica em Dermatovenereologia. Pretende-se sensibilizar para a importância da dor e contribuir para a redução da dor não controlada e a humanização dos cuidados prestados ao doente dermatológico. Nesta primeira parte da revisão, são abordados os aspetos epidemiológicos, a definição e o modelo conceptual atual para a compreensão da dor, bem como os fundamentos do tratamento da dor aguda peri-operatória.

This study aimed to analyze the perception of the nursing team regarding the assessment and management of pain performed in a pediatric unit. This is a qualitative, observational, prospective, and cross-sectional study. Data were collected through semi-structured interviews with the nursing team from a pediatric unit of an university hospital in the city of Londrina - Paraná, in the period from June to August 2009, and analyzed according to Mayan. In total, 31 professionals of the nursing team participated in this study, 4 nurses and 27 from other nursing categories. It was verified that less than half of the professionals attended training courses for pain assessment often carried out in this hospital. However, most stated to perform the assessment of pain as the 5th vital sign for all children. The facial scale is the most used by the team, although only 44% had correctly described the technique of use. Other professionals also reported that they did not use any scale to assess pain. The main difficulty pointed by the nursing team was regarding assessment of pain in infants. Regarding the unit's assessment of pain in general, most of the professionals think that they need to improve, reporting that other professionals do not assess pain all the times, or do it incorrectly. Nevertheless, everyone considered pain assessment of major importance in childcare. It is concluded that there is still a lack of knowledge and awareness about child's pain in the nursing team.