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Gerenciamento da dor após a cirurgia

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Qual dor esperar, como usar corretamente os analgésicos da alta hospitalar e quando ligar.

Updated Apr 2026
Uma ilustração desenhada à mão de comprimidos para alívio da dor.
A maioria das dores pós-operatórias do membro superior é bem controlada com paracetamol regular mais um anti-inflamatório, sendo que comprimidos mais fortes são reservados para os primeiros dias, quando necessário. Kieran Hirpara 4.0

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

Alguma dor após a cirurgia é normal e esperada. O objetivo do manejo da dor pós-operatória não é não sentir nada; é sentir-se confortável o suficiente para dormir, realizar seus exercícios e começar a se mover novamente.

O que esperar em termos de dor

A dor é geralmente mais intensa no dia da cirurgia e no dia seguinte, melhorando gradualmente durante as primeiras 1–2 semanas. Entre 4–6 semanas, a maioria dos pacientes apresenta apenas desconforto ocasional com a atividade. Pulsar ou dor surda à noite é comum na primeira semana; manter o braço elevado sobre travesseiros costuma ajudar.

Se a sua operação foi realizada sob anestesia local, a área ficará adormecida por aproximadamente 6–12 horas após o procedimento. Inicie o uso dos seus analgésicos habituais antes de passar o efeito da anestesia, e não após o início da dor. Após cirurgia do ombro sob bloqueio nervoso, a anestesia pode levar até uma semana para recuperar completamente, embora geralmente se resolva em 1–2 dias.

Dores agudas, semelhantes a choques elétricos, podem ocorrer à medida que os nervos se recuperam. São desagradáveis, mas normais, e geralmente desaparecem dentro de algumas semanas.

Os seus analgésicos de alta

Ser-lhe-ão prescritos analgésicos após o seu procedimento. Na maioria dos casos, são fornecidos antes de sair do hospital; se for dado alta após o encerramento da farmácia do hospital, receberá uma receita, por vezes enviada para o seu telemóvel por SMS, com um código impresso no seu pacote de alta. Qualquer farmácia a pode dispensar, incluindo a farmácia do hospital.

A receita tem duas camadas, e são utilizadas de forma diferente:

Analgésicos regulares: tome-os de acordo com o horário, não apenas quando a dor atinge o pico:

  • Paracetamol 1 g (duas comprimidos padrão) de 4 a 6 em 4 a 6 horas, não mais do que 4 g (oito comprimidos) em 24 horas
  • Ibuprofeno 400 mg de 8 em 8 horas, com alimentos, a menos que tenha uma contraindicação, como úlceras gástricas ou doença renal, ou lhe tenha sido dito para evitar anti-inflamatórios (o seu cirurgião informá-lo-á se a consolidação óssea for uma preocupação)

Analgésicos para dor de ruptura: apenas se a dor não estiver controlada pelos regulares:

Um analgésico mais forte é geralmente prescrito em conjunto: mais comumente tramadol, tapentadol (Palexia) ou oxicodona, e por vezes dois destes. Qual exatamente receberá depende do seu anestesiologista, por isso tome-os conforme indicado no rótulo da sua receita. Os padrões que se aplicam a todos os regimes dos nossos anestesiologistas:

  • Utilize os comprimidos para dor de ruptura apenas quando os analgésicos regulares não forem suficientes; não são um substituto para eles.
  • Se lhe tiverem sido dados dois analgésicos fortes, comece pelo mais suave; mude para o outro se não for suficiente ou se lhe causar náuseas.
  • À noite, um comprimido para dor de ruptura antes de deitar é frequentemente tudo o que é necessário. Na segunda semana, a maioria dos pacientes só precisa deles à noite, se precisar.
  • Alguns pacientes beneficiam de uma dose de ruptura antes das sessões de terapia da mão ou fisioterapia; o seu terapeuta informá-lo-á na primeira consulta se isso se aplica a si.
  • Procure reduzir os analgésicos fortes ao longo da segunda semana. Eles causam constipação e sonolência, e tornam-se menos eficazes quanto mais tempo os tomar.

A receita de alta é intencionalmente limitada. Se achar que não será suficiente para a sua recuperação, consulte o seu médico de família logo após a alta, em vez de esperar até ficar sem medicamento.

Efeitos colaterais importantes a conhecer

  • Prisão de ventre: tramadol, tapentadol e oxicodona todos a provocam. Consuma fibras e beba bastante água desde o primeiro dia; se isso não for suficiente, um saqueta de Movicol uma ou duas vezes ao dia resolve o problema.
  • Náuseas: se um analgésico forte lhe causar enjoos, alterne para o alternativo, se tiver um. Se lhe foi fornecido ondansetron na alta hospitalar, tome um comprimido para náuseas ou vómitos.
  • Sonolência: não conduza nem tome decisões importantes enquanto estiver a tomar analgésicos fortes.

Estratégias não farmacológicas

Estas funcionam surpreendentemente bem em conjunto com os comprimidos:

  • Gelo: coloque uma compressa de gelo sobre a ferida durante 15–20 minutos a cada hora ou conforme necessário na primeira semana. Nunca coloque gelo diretamente sobre a pele; embrulhe-o sempre num saco ou toalha (ver Calor vs. gelo)
  • Elevação: mantenha a mão mais elevada que o cotovelo, e o cotovelo mais elevado que o coração. Menos inchaço significa menos dor
  • Movimento: os exercícios prescritos provocam um ligeiro desconforto, mas reduzem a rigidez, que é o que causa a dor articular
  • Distração: assistir a algo que aprecia reduz genuinamente a perceção da dor nos primeiros dias

Quando ligar para nós

  • Dor que está piorando em vez de melhorar após os primeiros dias
  • Dor não controlada pelos medicamentos que foram prescritos
  • Dor intensa nova que surgiu subitamente
  • Dor ou inchaço na panturrilha (raro, mas pode ser sinal de um coágulo sanguíneo)
  • Dor no peito ou falta de ar: dirija-se ao serviço de urgência

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