Vol 9, No 2 (2015)


Nefopam as a component of multimodal postoperative analgesia: the result in the group of patients undergone surgery for head and neck tumors in context of multicenter trial

Balandin V.V., Gorobets E.S.


The goal of the study was to evaluate the affectivity of nefopam in postoperative pain management. Two hundred patients were enrolled into the prospective multicenter study on the base of 8 leading research centers of Russian Federation. The cohort includes 25 adult patients undergone surgery for head and neck tumors from Blokhin Russian Oncologic Research Center. All patient received analgesia for 3 postoperative days along the following scheme: nefopam 20mg i.v. 30 min before the end of the surgery, then every 8 hours combination of nefopam and NSAID. Visual- analogical 10-ball scale was used to evaluate analgesia. The results of the study suppose effectiveness and safety of nefopam as a component of postoperative multimodal analgesia.
Regional Anesthesia and Acute Pain Management. 2015;9(2):5-8
pages 5-8 views

Psychophysiological aspects of pain perception in early postoperative period

Stepanova Y.V., Mazurok V.A., Shchelkova O.Y.


Eighty six patients were divided in three groups depending on type of used surgery. During the preoperative period the patients were checked twice for pain sensitivity: after a finger prick and a venipuncture. Also, they were checked four times during the postoperative period, right after the awakening, 1, 3 hours after the awakening and 24 hours after the operation. Visual-analog scale was used to assess the pain. Psychic characteristics were studied using the “Integrative test of anxiety”, “Survey of neurotic disorders” and a questionnaire “Types of attitudes to diseases” Each patient was evaluated by 70 indexes in total, including 54 psychic ones. It was identified that the relationship between the pain intensity in postoperative wound and psychic characteristics of patients was far more expressed in latter time periods after the operation (3 hours and, especially, in 24 hours after the operation). Emotional and affective characteristics of a person and psychic conditions examined in preoperative period have the strongest relation with pain intensity.
Regional Anesthesia and Acute Pain Management. 2015;9(2):9-13
pages 9-13 views

Regional anesthesia and its effect on the status of higher mental functions after carotid endarterectomy

Shmelyov V.V., Neimark M.I.


The study includes 190 patients undergone reconstructive operations on carotid arteries for atherosclerotic stenosing lesions under different types of anesthesia. Neuropsycological examination was carried out dynamically using Montreal rating scale for evaluating of cognitive functions the battery of frontal dysfunction and the paste of drawing of hours. It was demonstrated that combined anesthesia based on regional blocks induces the minimal cognitive deficiency in patients with symptomatic and asymptomatic stenosis. In patients with asymptomatic stenosis anaesthesia with sevofluran and total intravenous anaesthesia with propofol is accompanied by developing of postoperational cognitive dysfunctions that is the most distinct after inhalation anaesthesia.
Regional Anesthesia and Acute Pain Management. 2015;9(2):14-21
pages 14-21 views

Comparative characteristic of risks for developing of adverse events and critical incidents during general and regional anesthesia. The analysis of 6 year clinical practice

Logvinenko V.V., Shen’ N.P.


The goal of the study was to compare incidence and structure of adverse events and critical incidents during general and regional anesthesia (RA) in hospitals of Tyumen' town and Tyumen' region in 2008-2013. It was revealed that the incidence of adverse events was significantly higher for RA in comparison with general anesthesia both in annual samples and in total sample. However the frequency of critical incidents was significantly lower for RA comparing with general anesthesia. The results suppose that Ra isn't absolutely safe method but the percentage of critical incidents following RA is decreasing as percentage of RA is increasing in analgesia structure. When analgesia risk is assessed it is important to highlight not only adverse events but also critical incidents the might be bounded with life-threatening prognosis much more tightly.
Regional Anesthesia and Acute Pain Management. 2015;9(2):22-28
pages 22-28 views

Postoperative pain: the state of problem and current trends in postoperative analgesia

Ovechkin A.M.


The lecture is devoted to the problem of postoperative pain management that is actual at the moment despite of a valuable progress in methods of analgesia and analgesic drugs. The paper includes the results of foreign epidemiologic studies concerned adequacy of postoperative analgesia. Clinical implication and pathophysiology of postoperative pain is presented in details as well as goals of poatoperative analgesia and current approaches to postoperative pain management. Modern medications which effects are proved by evidence based medicine are considered in the presented lecture together with their characteristics and contradictions. The Concept of multimodal analgesia is also described. The author proposed several chemes of perioperative analgesia for various surgeries.
Regional Anesthesia and Acute Pain Management. 2015;9(2):29-39
pages 29-39 views

Postoperative analgesia in children. What standards should we use?

Ul’rikh G.E., Zabolotskiy D.V.


The lecture devoted to analgesia in pediatrics. Various techniques for assessment of pain intensity in children are proposed. Thee authors consider different pathogenetic types of pain and corresponding approaches to its management, describe current analgesic drugs, conditions and schemes for applying them in pediatrics. Regial anesthesia has its distinct place in pain management, provides high level of postoperative analgesia and decreases stress-reply in newborns and children. Complications following regional blockades in children are rare that allow speaking about adequate safety of these methods. The lecture covers the questions concerned characteristics, indications and complications of regional blocks in children. The expertise of pain, understanding of drug pharmacology and particularities of children of different age are the base for pain management in postoperative period.
Regional Anesthesia and Acute Pain Management. 2015;9(2):40-45
pages 40-45 views

Anesthesia for Cesarean Section. Clinical guidelines

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There are presented clinical guidelines for anesthesia during Cesarean Section adopted by Profile board on anesthesiology and resuscitation on th 15 th of November 2013 and 10 th of June 2014.
Regional Anesthesia and Acute Pain Management. 2015;9(2):46-57
pages 46-57 views

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