Vol 9, No 3 (2015)

Lornoxicam, one of NSAIDs, is considered as effective medication for postoperative analgesia. One of the well-known side effects of NSAIDs is hypocoagulation which can be dangerous in neurosurgery. The goal of this study was assessment of lornoxicam influence on hemostasis in perioperative period. Materials and methods: 20 patients after craniotomy for tumor removal were enrolled in the study. Lornoxicam was used in “scheduled” dosing mode: 8 mg during anesthesia induction, followed by 8 mg each 8 hours for 3 days. TEG and PFA analysis were used for hemostasis assessment on 0,1,3 and 5 days of perioperative period. Results: We didn't detected hypocoagulation in patients during the study. Moreover we noted a tendency for hypercoagulation in early postoperative period. It can be explained by hemostasis activation by intraoperative trauma. This effect is seemed more significant than hypocoagulation effect of NSAID in our group of patients. Conclusion: “Scheduled” dosing of lornoxicam don't inhibit hemostasis in neurosurgical patients.

The paper presents the results of clinical study conduced in order to compare the effectiveness of different non-opioid analgesics and adjuvants affecting the NMDA-receptors and applied for prophylaxis and management of acute postoperative pain. The study includes 347 patients undergone appendectomy, inguinal hernia repair, laparoscopic cholecystectomy. It was show that some non-opioid analgesics (NSAIDs) and adjuvans (ketamine, gabapentin) reduce pain intensity and opioid analgesics consumption for some surgical manipulations and are not effective for the other surgery. Complex prescription of NSAIDs, ketamine and gabapentin significantly reduces intensity of postoperative pain in all conditions and allows refusing from using of opioid analgesics.

The lecture discusses the question of pharmacodynamics and pharmacokinetics of local anesthetics and adjuvants applied for regional analgesia in pediatrics.

The paper describes comprehensively physiological changes in pregnant women with obesity. It also presents deep analysis of up-to-date publications devoted to anesthesia and analgesia in obese pregnant women. All proposed treatment protocols and guidelines for anesthesia and perioperative analgesia in pregnant women with obesity are base on modern statistical and expert analytical methods.