Vol 10, No 4 (2016)

Articles
Desyat' let pervomu zhurnalu Rossii, posvyashchennomu problemam regionarnoy anestezii i posleoperatsionnogo obezbolivaniya
Ovechkin A.M.
Abstract

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Regional Anesthesia and Acute Pain Management. 2016;10(4):215-218
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Strategy of perioperative
Garyaev R.V.
Abstract

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.

Regional Anesthesia and Acute Pain Management. 2016;10(4):220-230
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The modern state of analgesia after total hip replacement
Timerbaev V.H., Dolgasheva N.S., Genov P.G.
Abstract

Total hip replacement is an important orthopedic surgery allowing to increase high-activity profile and longevity of the elderly patients suffered from arthritis and proximal hip fracture. For the good outcome of the surgery we have to use enhanced recovery strategy which in turn needs performing adequate postoperative analgesia. Using painkillers only (per os, i.v., i.m., s.c.) after THR is not enough to reach this aim (well pain relief at rest and during movement) due to low analgesic potency of the non-opioid drugs and adverse reactions related to opioids, so, the regional analgesia methods are widely spread. Considered before as a «gold standard» epidural analgesia method is not quite suitable for the aged patients as so as the sympathetic and motor blocks hinder an enhanced recovery after THR. In recent decades the interest in peripheral regional analgesia methods has been gradually increasing. Fascia iliaca and psoas compartment blocks, local wound infiltration analgesia are getting the modern regional THR postoperative analgesia armamentarium. Each of them has some benefits and pitfalls and only face-to-face comparisons within the scope of clinical trials will give us the basic for the constituting the local and national post-THR analgesia guidelines.

Regional Anesthesia and Acute Pain Management. 2016;10(4):231-242
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Child and regional anesthesia - What for? Where? And how?
Zabolotskiy D.V., Koryachkin V.A.
Abstract
Regional anesthesia is experiencing a renaissance, which is certainly due to the possibility of an effective blockade of nociceptive impulsion from the surgery area, minimum pharmacological load during combined anesthesia, appropriate perioperative anesthesia and implementation of the equipment defining neuronal structure in routine practice. However, for the safe use of these techniques in pediatric practice, it is necessary to know the age-related anatomical and physiological characteristics of the child, the pharmacokinetics of local anesthetics and principles of their use. These issues are the focus of this review of the literature.
Regional Anesthesia and Acute Pain Management. 2016;10(4):243-253
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Multimodal analgesia in bariatric surgery
Neimark M.I., Kiselev R.V.
Abstract
This review is devoted to the treatment of postoperative pain in bariatric surgery. At present, the prevalence of patients with a high degree of obesity is an epidemic that leads steadily growing number of bariatric operations. Showing the risk factors in the traditional approach to the use of opioids in these patients, as well as the consequences of inadequate analgesia in these patients. Details are presented modern pharmacological agents acting on different levels nociceptive system. Substantiates the role of a multi-modal approach to perioperative analgesia, mandatory use of regional anesthesia. The attention to the visualization neuroaxial structures using ultrasound in the context of the implementation of the efficacy and safety of regional anesthesia in patients with morbid obesity. Possible prospects for pain control in bariatric surgery.
Regional Anesthesia and Acute Pain Management. 2016;10(4):254-261
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Pain syndrome after laparoscopic cholecystectomy
Sviridov S.V., Vedenina I.V., Taylor S.D.
Abstract
Laparoscopic cholecystectomy is the «gold» standard for the surgical treatment of patients with calculous cholecystitis. It is believed that laparoscopic cholecystectomy is not only safe, but also is painless in the postoperative period. At the same time the pain syndrome after laparoscopic cholecystectomy may be very serious. The article discusses the formation and localization of the pain syndrome, diagnostics and pharmacotherapy of the pain syndrome after laparoscopic cholecystectomy.
Regional Anesthesia and Acute Pain Management. 2016;10(4):262-272
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Prevention of chronic the postthoractomy pain syndrome in cancer surgery
Khoronenko V.E., Abuzyarova G.R., Malanova A.S.
Abstract
The review is concerned the actual problem - the prevention of chronic postthoracotomy pain syndrome in cancer surgery. The analysis of modern investigations and trends dedicated this problem is presented. The advantages and controversies of each method of perioperative management of patients with malignant pulmonary neoplasms underwent lung resections via thoracotomy approach are reported. The authors also present their original method, which reduces two times the incidence of chronic postthoracotomy pain syndrome.
Regional Anesthesia and Acute Pain Management. 2016;10(4):273-281
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The problem of acute postoperative pain in neurosurgical patients
Lubnin A.U., Imaev A.A., Solenkova A.V.
Abstract
This is review article concerned to problem of acute postoperative pain in neurosurgical patients. Many ears ago it was widely accepted that wast majority of neurosurgical patients don't have any pain sensation after craniotomy. Following investigations show that it mistake. In this article we discuss new data on statistics of acute postoperative pain after intracranial and spinal neurosurgical interventions, patophysiology of acute p/o pain and various methods preventing and treatment of this pain sensation. Regional scalp block, NSAID, i/v morphine on PCA approach, transdermal therapeutic forms of fentanyl and regional analgesia in spinal neurosurgery - are most perspective directions in solving of this problem.
Regional Anesthesia and Acute Pain Management. 2016;10(4):282-290
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The use of epidural analgesia in the treatment of acute pancreatitis
Sitkin S.I.
Abstract
Acute pancreatitis (AP) is one of the most frequent gastrointestinal diseases requiring hospital of microcirculation and ischemia of the pancreas are the main causes of pancreatic necrosis. There is currently no specific therapy of acute pancreatitis. Symptomatic therapy admissions worldwide. AP has an overall mortality of 1%, increasing to 30% in its severe form. Violation focuses on aggressive rehydration, early nutrition, acceptable analgesia, oxygenation, and use of antibiotics is the main treatment for OP. Increasing evidence shows benefits of TEA in animal AP: improved splanchnic and pancreatic perfusion, improved pancreatic microcirculation, reduced liver damage, and significantly reduced mortality. This article provides an overview of research on the use of thoracic epidural anesthesia in the treatment of acute pancreatitis.
Regional Anesthesia and Acute Pain Management. 2016;10(4):291-296
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Neuraxial anesthesia in obstetric patients with intracranial hypertension: ten questions and answers
Shifman E.M., Arustamyan R.R., Lubnin A.U., Kulikov A.V.
Abstract
This review covers the actual problem - the use of neuraxial anesthesia in obstetrics in women with intracranial hypertension of various etiologies. Neuraxial anesthesia in pregnant patients with intracranial pathology is possible, but this requires an individual approach, a joint discussion of anesthesiologists, obstetricians, neonatologists and neurologists. An assessment of the likelihood of increased intracranial pressure and related potential adverse effects.
Regional Anesthesia and Acute Pain Management. 2016;10(4):297-310
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