Regional Anesthesia and Acute Pain ManagementRegional Anesthesia and Acute Pain ManagementРегионарная анестезия и лечение острой боли1993-65082687-1394Eco-Vector4280810.17816/RA42808ArticlesСтатьиResearch ArticleStrategy of perioperativeСтратегия периоперационного регионарного обезболиванияGaryaevRoman V.ГаряевРоман Владимирович

MD, PhD, Senior Researcher of the Department of anesthesiology and resuscitation, N.N. Blokhin Russian Cancer Research Center of MH of RF

к.м.н., старший научный сотрудник отделения анестезиологии-реанимации НИИ клинической онкологии РОНЦ им. Н.Н. Блохина МЗ РФ

romvga@mail.ruN.N. Blokhin Russian Cancer Research Center of MH of RFФГБУ «Российский онкологический научный центр им. Н.Н. Блохина» МЗ РФ15122016104VOL 10, NO4 (2016)ТОМ 10, №4 (2016)22023024082020Copyright ©; 2016, Eco-VectorCopyright ©; 2016, ООО "Эко-Вектор"2016Eco-VectorООО "Эко-Вектор"https://rjraap.com/1993-6508/article/view/42808

Central and peripheral regional blockade for surgery are the most suitable, pathogenetically reasonable methods than any other pain relief methods. Advantages of regional blockades are implemented in their extension throughout the required post-operative period. It is proven to reduce the frequency of major complications of the circulatory system, respiratory system, and gastrointestinal tract, as well as mortality rates using prolonged epidural analgesia. Unfortunately, the risk of severe hemorrhagic and infectious complications limits the widespread use of neuraxial blockade, so you should not use them at all patients in a row. The strategy of regional anesthesia is not the expansion of the indications for the central blockades, and in choosing the most appropriate for a particular intervention of regional techniques in order to maximize the realization of its benefits and reduction the risk of complications.

Центральные и периферические регионарные блокады для обеспечения хирургических вмешательств являются наиболее подходящими, патогенетически обоснованными методами по сравнению с любыми другими способами обезболивания. Преимущества регионарных блокад реализуются при их продлении в течение всего необходимого послеоперационного периода. Доказано снижение частоты больших осложнений со стороны системы кровообращения, дыхания и желудочно-кишечного тракта, а также смертности при использовании продленной эпидуральной анальгезии. К сожалению, риск развития тяжелых геморрагических и инфекционных осложнений ограничивает широкое использование нейроаксиальных блокад, поэтому не следует применять их у всех больных подряд. Стратегия регионарного обезболивания заключается не в расширении показаний для центральных блокад, а в выборе наиболее подходящей при конкретном вмешательстве регионарной методики с целью максимальной реализации ее преимуществ и нивелирования риска осложнений.

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