Vol 4, No 1 (2010)

It's presented data of multicenter trial undertaken for determining physical and psychological contributors of postoperative pain syndrome. Course of immediate postoperative period was investigated in 126 patients. General anesthesia is conducted in the 54 patients and regional one (nerve block, spinal, epidural or combination) was the option in the 72. The results of our study suggest that solution of postoperative pain problem lies not only in improving of medical treatment but also in addressing psychological issues as well as supporting cooperation between patient and physician.

The study focused on changes of inflammatory (Il-1, Il-6, TNF-α) and anti-inflammatory (Il-10) cytokine serum level in women with 26-34 weeks gestation having severe preeclampsia and on the contribution of ropivacaine's epidural infusion into these changes. In our trial substantial increase in plasma concentration of inflammatory cytokines and decrease of anti-inflammatory one were common findings in pregnant woman with severe preeclampsia. Conducting of labour ropivacaine epidural infusion was associated with sufficient decrease in serum concentration of inflammatory Il-6 and increase in serum concentration of anti-inflammatory Il-10 that may be the evidence of anti-inflammatory effect of the technique.

Aim of the study was to determine an optimal anesthesia technique for aorta-femoral bypass surgery in patients with chronic obstructive pulmonary disease (COPD). Material and methods. 58 patients with COPD undergoing aorta-femoral (bi-femoral) bypass were enrolled. We investigated oxygen transport and serum level of cortisol during surgery and in the early postoperative period. We also measured PO 2/FiO 2 ratio. The patients were randomized in three groups - general anesthesia (GA) (n=19), total intravenous anesthesia (TIVA) (n=19), continuous spinal anesthesia (CSA) (n=20). Results. PO 2/FiO 2 ratio was significantly higher in CSA group in comparison with GA and TIVA groups. For the patients under CSA cortisol serum level was lower then in GA and TIVA patients but statistically significant difference was reached only between GA and CSA groups at the second day after operation. Conclusions CSA is the most appropriate option in patients with COPD undergoing abdominal aortic surgery.