Halil İbrahim ÖLÇÜM, Mehmet Emrah KARADERE

Opioid Kullanım Bozukluğu arındırma sürecinde ağrının yönetimi: Konfor Kuramı ve Nörobilim temelinde bir yaklaşım

Yasadışı opioid kullanımı son yıllarda giderek artmaktadır. Opioid Kullanım Bozukluğunda tedavi, arındırma ve sürdürüm olmak üzere iki aşamadan oluşmaktadır. Arındırma süreci yaklaşık bir hafta süren, yerine koyma tedavisini kapsar. Genellikle arındırma tedavisinin son evresinde kullanılan buprenorfin/nalokson kombinasyonunun azaltılarak kesilmesi ve sürdürüm tedavisinde kullanılacak olan naltrekson hidroklorür ilacına başlanması tercih edilmektedir. Bu geçiş sürecinde ağrı başta olmak üzere ortaya çıkabilen yoksunluk belirtilerinin etkin yönetilememesi, tedavide kalma ile ilişkilidir. Bu kritik süreçte izlem, ek ilaç desteği ve ilaç dışı müdahaleler ile hastanın tedavide kalmasını sağlamakta psikiyatri hemşirelerinin rolü önemlidir. Bu derleme çalışmasında arındırma sürecinde ağrı yönetimine konfor kuramı ve nörobilim temelinde bir yaklaşım getirilmesi amaçlanmıştır.

Anahtar Kelimeler:

Opioid Kullanım Bozukluğu, Arındırma, Ağrı, Konfor, Nörobilim

Management of pain in Opioid Use Disorders during detoxification: A psychiatric nursing approach with the context of Comfort Theory and Neuroscience

Use of the illicit opioid has been increasing in recent years. Treatment of opioid use disorder consists of two phases: detoxification and maintenance. Detoxification process includes replacement therapy, which takes approximately one week. Generally, in the last phase of detoxification, slowly tapering the buprenorphine/naloxone doses and continuing with the naltrexone is preferred. In this medically managed withdrawal period, ineffective management of withdrawal symptoms -especially pain- related with retention in treatment. The role of psychiatric nurses is important for retention in treatment with follow-up, additional drug support and non-pharmacological interventions. The aim of this review is introduce an approach on the basis of comfort theory and neuroscience to pain management in the detoxification process.

Keywords:

Opioid Use Disorder, Detoxification, Pain, Comfort, Neuroscience,

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