Vol 7, No 1 (2013)

The work includes the overview of potential nerve block complications, represents comprehensive and deep analysis of possible reasons. Clinical and physiological manifestations of each complication are considered as well as its diagnostics and methods of prophylaxis and treatment. The work includes clinical case descriptions to show practical application of theoretical statements.

High frequency of postamputational phantom pain syndrome (PPS) and poor efficiency of measures of its prophylaxis and managements determined the main goal of the study: to develop technology for prevention PPS during elective amputation of upper or lower extremity. The study resulted in purposeful choice of measures complex for special drug prophylaxis (SDP). Theoretically each of these measures is able to block specific peripheral or central mechanism of PPS. The SDP includes anticonvulsant (pregebalin or gabapentin), glucocorticosteroid (dexamethasone), protease inhibitor (aprotinin), NMDA-receptors antagonist (ketamine) and thricyclic antidepressant (amitriptyline). Pilot prospective controlled clinical study was conducted in order to investigate the SDP efficiency (n=28), added according to defined scheme to systemic (n=14) or combined (systemic and epidural, n=14)) anesthesia/analgesia following by postoperative prophylactic therapy. Complex assessment of the results including questionnaire of neuropathic pain diagnostics “Pain Detect” revealed that SDP symptoms were absent in all examined patients undergone amputation regardless of methods of intra- or postoperative anesthesia and analgesia. The novelty of developed technology is confirmed by patent on invention. Total number of patients undergone the amputation of lower (n=26) or upper (n=21) extremity equaled to 47 individuals. No PPS was recorded in each patient. The period of observation was from 6 months to 4 years.

The lecture is dedicated to different types of pain, its reasons and localization as well as neural ways of pain signal transmitting and corresponding methods of prevention and pain management. The lecture includes critical overview of drugs and anesthetic agents applied for treating pain of different etiology.

The concept of linear relationship between parameters and its investigation using methods of correlation analysis are considered in present paper. Graphical and subject interpretation of correlation coefficient values obtained during statistical processing of experimental data is discussed on the base of clinical study.