Regional Anesthesia and Acute Pain ManagementRegional Anesthesia and Acute Pain ManagementРегионарная анестезия и лечение острой боли1993-65082687-1394Eco-Vector3605810.17816/RA36058ArticlesСтатьиResearch ArticleTransdermal therapeutic system TRANSTECK and DUROGESIK in postoperative analgesia after major surgery of morbid obesityТрансдермальные терапевтические системы ТРАНСТЕК и ДЮРОГЕЗИК как средства послеоперационного обезболивания в радикальной хирургии морбидного ожиренияEpsteinS. L.ЭпштейнС. Л.StorozhevV. Yu.СторожевВ. Ю.AzarovaT. M.АзароваТ. М.RomanovB. V.РомановБ. В.SablinI. A.СаблинИ. А.VdovinV. V.ВдовинВ. В.MartynovA. N.МартыновА. Н.YashkovYu. I.ЯшковЮ. И.BekuzarovD. K.БекузаровД. К.Multi-field Clinic “Center of Endosurgery and Lithotripsy", MoscowМногопрофильная клиника «Центр эндохирургии и литотрипсии», Москва1506201042VOL 4, NO2 (2010)ТОМ 4, №2 (2010)132421072020Copyright ©; 2010, Eco-VectorCopyright ©; 2010, ООО "Эко-Вектор"2010Eco-VectorООО "Эко-Вектор"https://rjraap.com/1993-6508/article/view/36058

Efficacy of postoperative analgesia with transdermal therapeutic system - TRANSTECK (buprenorphine) and DUROGESIK (fentanyl) was assessed in 70 morbidly obese patients who had biliopancreatic bypass surgery under general anesthesia with sevofluarine, fentanyl, rocuronium. The 30 patients were assigned to postoperative analgesia with transteck, and in the 40 patients durogesik was administered. Our results indicate that transdermal therapeutic systems present effective postoperative pain treatment in patients with morbid obesity undergoing biliopancreatic bypass surgery.

У 70 пациентов с морбидным ожирением после операций билиопанкреатического шунтирования, выполненных под эндотрахеальным наркозом севофлюраном, фентанилом, рокурониумом, была оценена эффективность послеоперационной анальгезии трансдермальными терапевтическими системами (ТТС) ТРАНСТЕК (бупренорфин) и ДЮРОГЕЗИК (фентанил). У 30 больных был использован ТРАНСТЕК, у 40 - ДЮРОГЕЗИК. Результаты исследования показали, что трансдермальные терапевтические системы ТРАНСТЕК и ДЮРОГЕЗИК являются эффективными средствами послеоперационного обезболивания у больных с морбидным ожирением после операций билиопанкреатического шунтирования.

morbid obesitybiliopancreatic bypass surgerytransdermal therapeutic systemsморбидное ожирениебилиопанкреатическое шунтированиетрансдермальные терапевтические системыременко А. А., Урбанов А. В., Аветисян М. И. Применение трансдермальной терапевтической системы бупренорфина «транстек» для обезболивания в ранние сроки после кардиохирургических операций // Анестезиология и реаниматология. 2006; 5: 40-44.Справочник Видаль. Лекарственные препараты в России. 2007. 1618 с. АстраФарм-Сервис.Ферранте М., ВейдБонкор Т. Послеоперационная боль. Медицина. 1998.Эпштейн С. Л. Сравнительная эффективность и безопасность современных методик анестезии и послеоперационной анальгезии в хирургии морбидного ожирения. Consilium Medicum // Хирургия. 2008; 2: 12-20.Эпштейн С. Л., Сторожев В. Ю., Азарова Т. М. и др. Периоперационное анестезиологическое обеспечение больных с морбидным ожирением при операциях билиопанкреатического шунтирования // Вестник интенсивной терапии. 2008; 3: 69-73; 4: 31-36.Яшков Ю. И., Эпштейн С. Л., Романов Б. В., Саблин И. А. Синдром длительного раздавливания с исходом в острую почечную недостаточность после операции по поводу сверхожирения // Анналы хирургии. 2006; 2: 78-80.Adams J., Muphy P Obesity in anaesthesia and intensive care // Br. J. Anaesth. 2000; 85(1): 91-108.Aurilio C., Pace M., Passavanti M. Transdermal buprenorphine combined with spinal morphine and naropin for pain relief in chronic peripheral vasculopathy // Minerva Anesthesiol. 2005; 71: 445-449.Bellamy M., Struys M. Anaesthesia for the overweight and obese patient // Oxford University Press. 2007. 108 p.Bray G. Pathophisiology of obesity // Am. J. Clin. Nutr. 1992; 55(Suppl): 488-494.Breivik H. Postoperative pain management: why is it difficult to show that it improves outcome? // E. J. A. 1998; 15: 748751.Budd K. Buprenorphine and the transdermal system: the ideal match in pain management // Int. J. Clin. Pract. Suppl. 2003; 133: 9-14.Carr D., Goudas L. Acute pain // Lancet. 1999; 353: 20512058.Chawla G., Drummond G. Fentanyl decreases end-expiratory lung volume in patients anaesthetized with sevoflurane // Br. J. Anaesth. 2008; 100: 411-414.Cheah M., Kam P Obesity: basic science and medical aspects relevant to anaesthetists // Anaesthesia. 2005; 60: 10091021.Chelly J. An iontophoretic fentanyl HCL patient-controlled transdermal system for acute postoperative pain management // Expert Opin Pharmacother. 2005; 6: 1205-1214.Chelly J., Grass J., Houseman T., Minkowitz H., Pue A. The safety and efficacy of fentanyl patient-controlled transdermal system for acute postoperative analgesia: a multicenter, placebo-controlled trial // Anesth. Analg. 2004; 98: 427-433.Covino B., Scott D., McClure J. Handbook of epidural anaesthesia and analgesia. 1999; 207 p.Dalens B. Regional anaesthesia in the morbidly obese patient: children. XXYIII annual ESRA congress // Highlights in regional anaesthesia and pain therapy. 2009; 238-243.Eberhart L. Patient controlled analgesia techniques: oral / transmucosal PCA. XXYIII annual ESRA congress // Highlights in regional anaesthesia and pain therapy. 2009; 160161.Ettinger J., Marcilio C., Santos-Filho P., Azaro E., Mello C., Fahel E., Batista P Rhabdomyolysis: diagnosis and treatment in bariatric surgery // Obes Surg. 2007; 17: 525-532.Evans H., Easthope S. Transdermal buprenorphine // Drugs. 2003; 63: 1999-2010.Fentanyl transdermal official FDA information, side effects and use (http://www.drugs.com/pro/fentanyl-transdermal. htm1#A02A9CB6-35CF-4F01-A980-C3733E0F861A).Fernandez A., DeMaria E., Tichansky D. Experience with over 3000 open and laparoscopic procedures: multivariate analysis of factors related to leak and resultant mortality // Surg. Endosc. 2004; 18: 193-197.Greenway S., Greenway F., Klein S. Effects of obesity surgery on non-insulin-dependent diabetes mellitus // Arch. Surg. 2002; 137: 1109-1113.Griessinger N., Sittl R., Likar R. Transdermal buprenorphine in clinical practice-a post-marketing surveillance study in 13179 patients // Curr. Med. Res. Opin. 2005; 21(8): 11471156.Hartrick C., Bourne M., Gargiulo K., Damaraju C., Vallow S., Hewitt D. Fentanyl iontophoretic transdermal system for acute-pain management after orthopedic surgery: a comparative study with morphine intravenous patient-controlled analgesia // Reg. Anesth. Pain Med. 2006; 31( 6): 546-554.Heller A. Optimizing clinical pathways using regional anaesthesia. Refresher course lectures. Madrid, Euroanaesthesia. 3-6 june 2006. P. 1-6.Howell P., Gambling D., Pavy T. Paitient-controlled analgesia following caesarean section under general anaesthesia: a comparison fentanyl with morphine // Can. J. Anaesth. 1995; 42: 41-45.Kehlet H. Fast-track surgery-the role of anaesthesiologist and perioperative pain management. Refresher course lectures. Munich. 2007. P. 153-155.Lambert D., Marceau S., Forse R. Intra-abdominal pressure in the morbidly obese // Obes. Surg. 2005; 15: 1225-1232.Leykin Y. Regional anaesthesia in the morbidly obese patientsperioperative cosideration. XXYIII annual ESRA congress // Highlights in regional anaesthesia and pain therapy. 2009. P. 226-233.Lopez J., Sung J., Anderson W. Is bariatric surgery safe in academic centers? // Am. Surg. 2002; (68): 820-823.Malavasi L.M., Augustsson H., Jensen-Waern M., Nyman G. The effect of transdermal delivery of fentanyl on activity in growing pigs // Acta Vet. Scand. 2005; 46(3): 149-157.Miaskowski C., Crews J., Ready L., Paul S., Ginsberg B. Anesthesia- based pain services improve the quality of postoperative pain management // Pain. 1999; 80: 23-29.Nielsen K., Guller U., Susan M., Streele S., Stephen M., Klein S., Greengrass R., Pietrobon R. Influence of obesity on surgical regional anesthesia in the ambulatory setting: an analysis 0f 9038 blocks // Anesthesiology. 2005; 102: 181-187.Rainaldi M.P. Regional anaesthesia in the morbidly obese obstetric patient. XXYIII annual ESRA congress // Highlights in regional anaesthesia and pain therapy. 2009. P. 234-237.Rasheid S., Banasiak M., Gallagher S. Gastric bypass is an effective treatment for obstructive sleep apnea in patients with clinically significant obesity // Obes. Surg. 2003; 13: 58-61.Rawal N., Langford R. Current practices for postoperative pain management in Europe and the potential role of the fentanyl HCL iontophoretic transdermal system // EJA. 2007; 24(4): 299-308.Rogers A., Walker N., Schug S., McKee A., Kehlet H., van Zandert A. Reduction of postoperative mortality and morbidity with epidural and spinal anaesthesia: results from overview of randomized trails // B M J. 2000; 321: 1-12.Schein M., Wittmann D., Aprahamian C. The abdominal compartment syndrome: the physiological and clinical consequences of elevated intra-abdominal pressure // J. Am. Coll. Surg. 1995; 180: 745-753.Siafaka L., Rellia P., Argyra E., Iakovidou N., Sykiotis C., Vadalouka A. Pharmacokinetic profile and efficacy of fentanyl transdermal delivery system for acute postoperative pain after intra-abdominal gynecologic surgery for cancer // Pain Practice. 2004; 4(2): 98-104.Swenson B., Hollenbeak C., Koltun W. Hospital costs and risk factors associated with complications of the ideal pouch anastomosis // Surgery. 2002; 132(4): 767-773.Viscusi E., Reynolds L., Chung F., Atkinson L., Khanna S. Patient-controlled transdermal fentanyl hydrochloride vs intravenous morphine pump for postoperative pain: a randomized controlled trail // JAMA. 2004; 291: 1333-1341.Westerdahl E., Lindmark B., Eriksson T. Deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery // Chest. 2005; 128: 3482-3488.Wulf H. Combined epidural with general anaesthesia vs. general anaesthesia alone-in major abdominal surgery. XXYI annual ESRA congress. Valencia, Spain, September 12-15, 2007. P. 238-239.Zoremba M., Dette F., Gerlach L., Wolf U., Wulf H. Shot-term respiratory physical treatment in the PACU and influence on postoperative lung function in obese adults // Obes. Surg. 2009; 19: 1346-1354.