Abstract

SAENZ-CAMPOS, Desirée  and  SANCHEZ-ARREDONDO, Carmen Ma. Análisis de la concordancia prescripción- administración de analgésicos durante el postoperatorio inmediato. Acta méd. costarric [online]. 2005, vol.47, n.4, pp.186-191. ISSN 0001-6002.

Objective: To compare the prescription and administration of postopertaive analgesics (first 24 hours) in patients who underwent orthopedic surgery. Methods: Observational study. Information was obtained from the medical charts of 60 patients (30 female and 30 male), who underwent elective orthopedic surgery of the extremities at a general hospital; ASA I (80%) and ASA II (20%), none with documented allergy to analgesics or anti-inflammatory agents. We performed crossed confirmation with the nurse' s chartboard and patients interviews. Variables: fulfillment of the prescription (total administerd doses: 120 doses of diclofenac or 180 doses of tramadol), fulfillment of the dose (real application of prescribed dose: diclofenac 75 mg and tramado150 mg), fulfillment of intervals (temporary deflection of 12 hours for diclofenac and of 8 hours for trramadol), and prescription-administration variations (additional applications or omissions). Descriptive analisis. Results: All patients were prescribed with diclofenac; 63.3% with 75 mg (1 vial) every 12 hours LM., and tramadol 50 mg (1/2 vial) every 6 hours S.C. Diclofenac: 50% received only one dose, 33.4% two doses, and one patient received tree doses; prescription' s fulfillment = 59.2%. Second dose 14.86 + 4.33 hours after the first dose, interval's fulfillment = 18.3% (+3 hours delay). Tramadol: 68.0% received one dose and 20% received two doses; prescription's fulfillment = 32.8%. Second dose 12.81 + 6.07 hours after the dirst dose; interval' s fulfillment = 37.5% (+5 hours delay). For both drugs: dose's fulfillment = 100%. Variations 21.7%: 2 patients received tramadol without prescription, the administration of the drug was omitted in 11 patients. Conclusions: The observed drug administration does not adjust to the prescribing profile, at least for the first 24 hours after surgery as inpatient care. The drug administration must improve towards the patients benefit.

Keywords : acute pain; postoperative pain; diclofenac; tramadol; prescription; compliance.