Ocorrência de trauma vascular periférico entre mulheres em contexto anestésicocirúrgico: estudo transversal

Abstract

Intravenous therapy is widely used in healthcare environments, with peripheral veins being the first option of use in the anesthetic-surgical context. Thus, vascular trauma can occur due to the puncture of blood vessels due to biological, (bio) chemical and mechanical causes and whose manifestations can be identified early or late. The general objective of the study was to analyze the occurrence of vascular trauma resulting from the process of puncture of peripheral vessels in anesthetic-surgical context. Method: descriptive cross-sectional study. The sample was chosen by type and participants were selected for convenience, women submitted to the anesthetic-surgical approach, considering the evaluation of the insertion site of the peripheral venous device after its removal. The data collection instrument was structured according to the variables of interest: 1) Characterization of women undergoing anesthetic-surgical procedure; 2) Anesthetic-surgical experience; 3) Characterization of the venipuncture process; 4) Occurrence of vascular trauma; 5) Photographic record of the vessel puncture site. The participants were recruited through an individual invitation made in the environment of the surgical hospitalization sector. Result: 189 women participated in the study, with an average age of 34.41 years, who underwent cesarean section (51.9%) or video surgery (48.1%). The most used anesthetic techniques were spinal anesthesia (50.3%) and combined anesthesia (38.6%). Most peripheral venous punctures were performed in articulation (74.1%) with jelco 18G (56.6%) and the residence time was 12 to 24 hours (77.7%). The occurrence of vascular trauma was observed in 67.2% of the participants, with 46.1% presenting between three and five manifestations of trauma. The most common manifestations were pain (64.0%), erythema (63.0%), edema (52.4%), temperature changes (51.0%) and skin maceration (28.6%). The photographic evidence indicated the use of a non-sterile porous cover, making it difficult to visualize the insertion site and early identification of signs of vascular trauma. In addition, the presence of blood residue in the circuit, absence of stabilization of the catheter, open system and elbowing of the circuit point contributing factors to the occurrence of vascular trauma. Conclusion: the occurrence of vascular trauma was high in this investigation, considering that this event can be preventable. Nursing actions such as effective participation in the process of standardization of inputs, review of protocols, training of the team, inclusion of technologies for visualization of the venous network and patient involvement in this process, seeking their safety, in addition to the adoption of strategies for the prevention of vascular trauma consolidated in the literature, can contribute to reducing the occurrence of this event.