Does nursing supervision influence the pain, comfort, and risk of local hemorrhage-related complications in patients after surgical restoration of carotid patency?

Aim of the study: Postoperative pain has adverse effects on patients’ psychological state and functioning of numerous organs. Comfort of patients after carotid surgery depends mostly on the severity of local haemorrhage-related complications. Dementia disorders in these patients increase the risk of improper drug administration. The aim of this study was to assess the impact of nursing supervision of drug administration on the risk of haemorrhage-related complications (bruises and ecchymosis) and the comfort of patients after carotid surgery.

Material and methods: 115 patients operated for carotid stenosis. Diagnostic survey and direct clinical assessment.

Results: Nursing supervision of drug administration was exercised in 21% of the patients. Ecchymosis considerably contributed to the incidence of clinically substantial local oedema – 22.77% (23) of the group without ecchymosis vs. 77.23% (78) of the group with ecchymosis (p = 0.023). The proportion of haemorrhage-related complications therapy was significantly higher in patients receiving double antiplatelet (DAT) than in those taking acetylsalicylic acid (ASA) – 67% vs. 21% (p = 0.046). The increased pain has been confirmed to be caused by such factors as oedema of the wound, female sex, and in patients receiving chronic anticoagulation – bridge therapy with low-molecular heparin (LMH) before surgery. The proportion of haemorrhage-related complications was not higher in the group of patients with dementia being under close nursing supervision.

Conclusions: Local haemorrhage-related complications enhance the pain and influence the comfort of patients after surgery. Patients who are particularly predisposed to such problems but are under close nursing care are not at higher risk of local haemorrhage-related complications.