Intervenções de enfermagem no manejo da dor aguda no pós-operatório imediato: mapeamento de evidências por revisão de escopo

Abstract

Introduction: The immediate postoperative period comprises the first 24 hours after a surgical procedure. During this period, the patient is clinically vulnerable and frequently experiences acute pain. Acute pain is a frequent complication in the postoperative period, associated with significant discomfort and adverse clinical outcomes that can compromise patient recovery. Objective: To map and synthesize, in the scientific literature, the nursing interventions used in the management of acute pain in the immediate postoperative period. To demonstrate the knowledge gaps and opportunities for improvement regarding the lack of specific nursing protocols for managing acute pain in the postoperative period. Methodology: This is a scoping review conducted according to the methodology proposed by the Joanna Briggs Institute, with a protocol previously registered in the Open Science Framework (DOI: 10.17605/OSF.IO/AP3JD). The search for evidence sources was conducted in the PubMed/MEDLINE, Latin American and Caribbean Health Sciences Literature (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Embase databases, as well as in grey literature through Google Scholar, Open Access Theses and Dissertations (OATD), and Zenodo, from March to May 2026. Studies addressing nursing interventions aimed at managing acute pain in the immediate postoperative period in adults were included. No time frame was established; studies published in English, Spanish, and Portuguese (Brazil) were considered. References were organized and managed using Rayyan and Mendeley® software. The selection process was conducted by two independent reviewers in a blinded manner, with disagreements resolved by a third reviewer. Data extraction was performed using a previously developed instrument, in accordance with the recommendations of the Joanna Briggs Institute, followed by a descriptive synthesis to present the findings. Results: 4,507 studies were identified, including grey literature. After the selection and screening process using Rayyan and Mendeley®, 3,288 evidences were analyzed by reading the titles and full abstracts. A sample of 67 studies was obtained and read in full. Of these, 24 studies were included in the final sample, one through a reverse search. The final sample included studies predominantly in English (66.67%) and reviews (54.17%). Regarding the place of publication of the studies, the sample was heterogeneous: Brazil, the United States of America (USA), and China were the largest producers of evidence. The nursing interventions for managing acute pain in the immediate postoperative period were grouped into seven categories: 1) pain assessment and monitoring (use of pain scales: one-dimensional scale, numerical rating scale, visual analog scale, verbal rating scale, recording and monitoring, assessment of pain as the fifth vital sign, assessment of pain tolerance, home follow-up), 2) pharmacological interventions (administration of analgesics, patient-controlled analgesia, control of side effects and use of standard protocols), 3) non-pharmacological interventions (distraction and relaxation techniques through controlled breathing, positioning for comfort, therapeutic touch and massage, application of heat and cold, Transcutaneous Electrical Nerve Stimulation, virtual reality, auricular acupressure, acupuncture, aromatherapy, music therapy and spirituality practices), 4) emotional and psychosocial support, 5) health education and selfcare, 6) care planning and organization, and 7) interdisciplinary coordination. Conclusion: Several nursing interventions for the management of acute pain in the immediate postoperative period were mapped, highlighting that the care provided by nurses, although still fragmented, is multifaceted and encompasses clinical, managerial, educational, and psychosocial dimensions, reinforcing the complexity and centrality of nursing practice in this context.