Vol 8, No 2 (2014)


Postoperative analgesia in obstetrics and gynecology: foreign guidelines and our reality

Ovechkin A.M.


The paper presents complete overview of the problem of pain and analgesia after obstetric and gynecologic surgery. The proposed guidelines for solving this problem are adapted to reality and practice of clinics of Russian Federation. The article includes also the questions for prospective development of new analgesic schemes.
Regional Anesthesia and Acute Pain Management. 2014;8(2):5-16
pages 5-16 views

Hydrodynamics of hyperbaric solution for spinal anesthesia in the experiment

Lakhin R.E.


The hydrodynamics of hyperbaric solution streams through spinal needles of types and sizes by different administration routes was experimentally studied. Administration rates of not more than 1,0 ml/min were found to be allowed to ensure a laminar stream model. The rates of 1,0-3,0 ml/min led to the appearance of hydrodynamic instability-associated turbulence. The rate of over 3,0 ml/min gave rise to turbulence associated with the thickened jet interface. The hydrodynamic shock of fluid flow with an obstacle as a model wall is a reason for the turbulent spread of a hyperbaric solution on the glass spine model. This mechanism of turbulence does not depend on the type of a spinal needle. The size of spinal needles affected the volume of distribution. Infusion through thin needles at equal rates increased the strength of shock with the model wall and the area of spread of a dyed hyperbaric solution. The advantage of needles with a side hole to achieve unilateral hyperbaric solution spread was found at rates of 1,5-3,0 ml/min.
Regional Anesthesia and Acute Pain Management. 2014;8(2):17-25
pages 17-25 views

The use of nephopam for prophylaxis of acute opioid tolerance and postoperative pain management in cancer surgery

Khoronenko V.E., Petrova V.V., Stenina I.I.


The study was conducted in order to investigate effectiveness and safety of using of non-opioid central-acting analgesic Nefopam (Acu-pan) as a component of multimodal anesthesia and postoperative analgesia in major oncologic abdominal and small pelvis surgery. The medication showed its high effectiveness for prophylaxis of opioid-induced hyperalgesia and for treatment of postoperative shivering. The using of nefopam as a component of postoperative analgesia allowed decreasing the opioid analgesic consumption significantly and enabled to achieve complete pain relief and to escape CNS and respiratory depression. No atropine-like side effects of the applied dose of medication were registered in monitored patients.
Regional Anesthesia and Acute Pain Management. 2014;8(2):26-30
pages 26-30 views

Postoperative pain audit

Antipov A.A., Linev K.A., Pediashov V.S., Yakovleva G.A.


The study was conducted to assess adequacy of postoperative analgesia in surgical patients of Krasnoyarsk regional clinical hospital. The study included patients undergone elective surgery. The pain intensity was assessed using 10-bals visual-analog scale (VAS). The quality of sleeping during the first night following the operation as well as subjective feeling connected with postoperative pain were registered and evaluated. It was noted that using of regional anesthesia methods prolonged painless period and decreased number of complaints during first 24 hours after surgery.
Regional Anesthesia and Acute Pain Management. 2014;8(2):31-36
pages 31-36 views

Selected chapters from monograph «Spinal Anesthesia in Obstetrics» Post spinal puncture headache

Shifman E.M., Filippovich G.V.


The final part of lecture about post dural puncture headache (PDPH) is dedicated to clinical picture and problems of differential diagnostics of PDPH as well as different methods of its management. Apart conservative methods of PDPH treatment the epidural blood patch is considered in details. The procedure techniques, its features and potential complications are described comprehensively.
Regional Anesthesia and Acute Pain Management. 2014;8(2):37-48
pages 37-48 views

Neuroaxial anesthesia during Cesarean Section in parturients with kyphoscoliosis

Sitkin S.I., Ronenson A.M., Savelieva Y.V.


Use of neuraxial block in a patient with severe kyphoscoliosis is controversial. It is believed that severe kyphoscoliosis is a contraindication to neuraxial anesthesia. In this article, we describe two cases of successful epidural anesthesia in pregnant women with severe kyphoscoliosis. We suggest that a pregnant with severe kyphoscoliosis may be successfully managed by epidural anaesthesia for caesarean section.
Regional Anesthesia and Acute Pain Management. 2014;8(2):49-53
pages 49-53 views

Nonopioid anesthesia/analgesia and sedation in oncologic patient with long term drug abuse in anamnesis (clinical case)

Balandin V.V., Gorobets E.S.


The paper presents a case report of removal of giant parapharyngeal neurinoma on the neck in patient with long-term heroin addiction in anamnesis and persistent remission. This condition required to exclude applying of opioid analgesics in perioperative period. The problem was successfully solved with the help of multimodal anesthesia/analgesia and sedation basing on α 2 - adrenomimetic dexmedetomidine and central analgesic drug nefopam.
Regional Anesthesia and Acute Pain Management. 2014;8(2):54-57
pages 54-57 views

Perioperative management of patients with neuromuscular disease (project of FAR clinical guidelines)

Zabolotskih I.B., Lebedinskiy K.M., Belkin A.A., Butrov A.V., Kondratiev A.N., Lubnin A.Y., Magomedov M.A., Nikolaenko E.M., Ovechkin A.M., Shifman E.M., Shchegolev A.V.


The project of clinical guidelines proposed by Federation of anesthesiologists of Russia is dedicated to questions of perioperative management of patients suffering from neuromuscular diseases and other pathological conditions and disorders that involved interaction between neural and striated muscular systems.
Regional Anesthesia and Acute Pain Management. 2014;8(2):58-75
pages 58-75 views

MEDOO - new ways to doctor

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Regional Anesthesia and Acute Pain Management. 2014;8(2):76-78
pages 76-78 views

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