Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1016/j.bjan.2012.07.004
Brazilian Journal of Anesthesiology
Scientific Article

Náusea e vômito no pós-operatório: validação da versão em português da escala de intensidade de náuseas e vômitos pós-operatórios

Postoperative nausea and vomiting: validation of the portuguese version of the postoperative nausea and vomiting intensity score

Veiga Dalila; Helder Pereira; Carlos Moreno; Clarisse Martinho; Cristina Santos; Fernando José Abelha

http://dx.doi.org/10.1016/j.bjan.2012.07.004 Braz J Anesthesiol, vol.63, n4, p.340-346, 2013
PDF Português
PDF English
Downloads: 5
Views: 1731

Resumo

JUSTIFICATIVA E OBJETIVO: A Escala de Intensidade de Náuseas e Vômitos Pós-Operatórios (NVPO) foi desenvolvida para definir NVPOs clinicamente importantes. O objetivo deste estudo foi traduzir, retraduzir e validar a Escala de Intensidade de NVPO para uso em unidades de recuperação pósanestésica (RPA) portuguesas. MÉTODO: A Escala de Intensidade de NVPO foi traduzida e retraduzida de acordo com as diretrizes disponíveis. A equipe de pesquisadores conduziu um estudo prospectivo e observacional de coorte em uma RPA. Durante três semanas, avaliamos as NVPO em 157 pacientes adultos internados após cirurgia. As mensurações foram feitas com o uso da Escala Visual Analógica (EVA) nos intervalos de seis e 24 horas durante o período pós-operatório. Avaliamos a confiabilidade e a discordância do observador com o uso do coeficiente de correlação interclasses (CCI) e da medida de discordância baseada na informação (MDBI). Comparamos os escores EVA entre os pacientes com NVPO clinicamente significantes (> 50) e não significantes (< 50). RESULTADOS: Trinta e nove pacientes (25%) apresentaram NVPO em seis horas e 54 (34%) em 24 horas. Trinta e seis pacientes apresentaram náusea em seis horas e 54 em 24 horas. Entre os pacientes com NVPO, os escores de seis pacientes (15%) e nove pacientes (27%) foram clinicamente significantes na Escala de Intensidade de NVPO em seis e 24 horas, respectivamente. A confiabilidade foi boa tanto para os escores da Escala de Intensidade de NVPO quanto para EVA e a discordância entre observadores foi ligeiramente superior para EVA. A mediana dos escores EVA foi maior nos pacientes com escores clinicamente significantes na Escala de Intensidade de NVPO. CONCLUSÃO: A Escala de Intensidade de NVPO parece ser um instrumento de avaliação e monitoramento preciso e confiável de NVPO em RPA.

Palavras-chave

COMPLICAÇÕES, Pós-operatória, náusea, Questionários, RECUPERAÇÃO PÓS-ANESTÉSICA

Abstract

BACKGROUND AND OBJECTIVES: The Postoperative Nausea and Vomiting (PONV) Intensity Scale was developed to define clinically important PONV. The aim of this study was to translate, retranslate and validate the PONV Intensity Scale for use in Portuguese Post Anesthetic Care Unit (PACU) settings. METHODS: The PONV Intensity Scale was translated and back-translated in accordance with available guidelines. The research team conducted an observational and cohort prospective study in a PACU. One-hundred fifty-seven adult patients admiited after surgery over three weeks were evaluated for PONV. Measurements included nausea visual analogic scale (VAS) at 6 and 24 hours, postoperatively. We assessed reliability and observer disagreement using interclass correlation (ICC) and Information-Based Measure of Disagreement (IBMD). We compared VAS scores between patients with clinically significant (>50) and not significant (<50) PONV. RESULTS: Thirty-nine patients (25%) had PONV at 6 hours and 54 (34%) had PONV at 24 hours. Thirty-six and 54 patients experienced nausea at 6 and 24 hours, respectively. Among patients with PONV, 6 patients (15%) and 9 patients (27%) had a clinically significant PONV intensity scale score at 6 and at 24 hours, respectively. The reliability was good both for PONV intensity scale score and for VAS and observer disagreement was slightly higher for VAS. The median nausea VAS scores were higher in patients with clinically significant PONV Intensity score. CONCLUSIONS: The PONV Intensity Scale appears to be an accurate and reliable assessment and monitoring instrument for PONV in the PACU settings.

Keywords

Postoperative Care, Postoperative Nausea and Vomiting, Questionnaires, Recovery Room

References

Myles PS, Williams DL, Hendrata M, Anderson H, Weeks AM. Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10,811 patients. Br J Anaesth. 2000;84(1):6-10.

Gan TJ, Meyer TA, Apfel CC. Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2007;105(6):1615-1628.

Apfel CC, Läärä E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 1999;91(3):693-700.

Watcha MF. The cost-effective management of postoperative nausea and vomiting. Anesthesiology. 2000;92(4):931-933.

Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analgesia. 2006;102(6):1884-1898.

Wengritzky R, Mettho T, Myles PS, Burke J, Kakos A. Development and validation of a postoperative nausea and vomiting intensity scale. Br J Anaesth. 2010;104(2):158-166.

Parra-Sanchez I, Abdallah R, You J. A time-motion economic analysis of postoperative nausea and vomiting in ambulatory surgery. Can J Anaesth. 2012;59(4):366-375.

Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg. 2006;102(6):1884-1898.

McGrath B, Chung F. Postoperative recovery and discharge. Anesthesiol Clin North America. 2003;21(2):367-386.

Eberhart LH, Mauch M, Morin AM, Wulf H, Geldner G. Impact of a multimodal anti-emetic prophylaxis on patient satisfaction in high-risk patients for postoperative nausea and vomiting. Anaesthesia. 2002;57(10):1022-1027.

Myles PS, Reeves MD, Anderson H, Weeks AM. Measurement of quality of recovery in 5672 patients after anaesthesia and surgery. Anaesth Intensive Care. 2000;28(3):276-280.

Haller G, Stoelwinder J, Myles PS, McNeil J. Quality and safety indicators in anesthesia: a systematic review. Anesthesiology. 2009;110(5)::1158-1175.

Myles PS. Quality in anesthesia. Minerva Anestesiol.. 2001;67(4):279-283.

van den Bosch JE, Kalkman CJ, Vergouwe Y. Assessing the applicability of scoring systems for predicting postoperative nausea and vomiting. Anaesthesia. 2005;60(4):323-331.

Molassiotis A, Coventry PA, Stricker CT. Validation and psychometric assessment of a short clinical scale to measure chemotherapy-induced nausea and vomiting: the MASCC antiemesis tool. J Pain Symptom Manage. 2007;34(2):148-159.

Bodian CA, Freedman G, Hossain S, Eisenkraft JB, Beilin Y. The visual analog scale for pain: clinical significance in postoperative patients. Anesthesiology. 2001;95(6):1356-1361.

Wild D, Grove A, Martin M. Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. . .

Allen ML, Leslie K, Jansen N. Validation of the postoperative nausea and vomiting intensity score in gynaecological patients. Anaesth Intensive Care. 2011;39(1):73-78.

de Vet H. Observe reliability and agreement. Encyclopedia of Biostatistics. 2005:2166-2168.

Costa-Santos C, Antunes L, Souto A, Bernardes J. Assessment of disagreement: a new information-based approach. Ann Epidemiol. 2010;20(7):555-561.

Gan TJ, Meyer T, Apfel CC. Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg. 2003;97(1):62-71.

5dd4010c0e8825da1cc63493 rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections