Introduction
Acute cholecystitis mainly occurs from the complications of the gallstones. Usually, it results from blockage of the cystic duct further resulting to the accumulation of bile into the gallbladder. This could often lead to an irritation and swelling. Patients with this complication usually undergo a medical procedure to remove the gallbladder. Post-operative care is always critical as these medical procedures to eliminate the gallbladder usually lead to abdominal pain and frequent re-hospitalization where adherence is poor or the post-operative procedure is not responsive (White, 2005).
Question: Among female Hispanic, age 20 and above, with acute cholecystitis, from surgical floor, does non-narcotic pain medication help achieve or reduce frequent hospitalization from re-current abdominal pain as compared to non-medicine pain control in post-operative care?
Population:
Among female Hispanic, age 20 and above with acute cholecystitis is highly prevalent. In essence, gender, ethnicity and age are identified as influencing factors for acute cholecystitis. The Hispanic population is classified as a major risk group. On the other hand, females above the age of twenty are also identified as a risk group and this is more so during pregnancy. The study population is basically the Hispanic females, aged 20 and above, with acute cholecystitis and who have undergone surgical removal of gallbladder. Patients with cases of abdominal pain unrelated to acute cholecystitis are excluded from this study. On the other hand, patients who have been diagnosed as having allergic reactions to narcotic medication have been excluded. Similarly, patients with proven cases of mental illnesses and levels of physical or psychological; incapacitation are excluded.
Intervention
Post-op non-medicine pain management whichever the surgical procedure that is used for a patient with acute cholecystitis, either open cholecystectomy or laparoscopic, pain is a post-operative complication that occurs, increasing chances of re-hospitalization. Pain compromises the healing process and resumption to normal life. As a result of severe abdominal pain and delayed healing process may cause psychological and emotional disturbances to the patient. Use of narcotics as a pain management approach is accompanied by undesirable side effects such as sleepiness, low breathing rate, constipation, nausea, skin rash and difficulty during urination (White, 2005). Therefore, a non-medicine management approach is a better post-op intervention in terms of reducing pain and preventing other health and mental complications that may occur in the aftermath of an operation. Unlike other pain management approaches, on-medicine interventions are less expensive are patient-centered.
A non-medicine approach encompasses the use of distractions such as listening to music or engaging in any other leisure activity as a way of diverting attention away from pain. On the other hand, guided imagery can help in controlling pain and the post-op emotional burdens. For instance, a patient may close his/her eyes, exhale deeply and visualize him/her in a beautiful place as a way of gaining control of emotions. Similarly, "splinting" the stomach before coughing, perhaps using a pillow may reduce pain when coughing.
Comparison
A Narcotic-based intervention will be used as a control and as such; some members of the sample population will be put on opioids/narcotics as a pain control method. For the two groups, both the non-medicine and the narcotic, rates of re-hospitalization and post-op complications will be evaluated to establish the comparative advantages or disadvantages of a non-medicine approach towards pain control and management.
Outcome
- Reduced abdominal and other post-op complications
- Reduced re-hospitalization rates
Time
The follow-up will take a 12-week post-op period.
References
White, P. F. (2005). The changing role of non-opioid analgesic techniques in the management of postoperative pain. Anesthesia & Analgesia, 101(5S), S5-S22.
