Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Sep 2008
Clinical Trial[Multimodal approach to postoperative analgesia in patients with neuropathic pain].
Chronic neuropathic pain syndrome observed prior to surgery not only influences the intensity of pain, but also reduces the efficiency of selective use of analgesics. The purpose of the investigation was to study the efficiency of various analgesics and their combinations after lumbar microdiskectomy. ⋯ Their analgesic effect was evaluated using a visual analogue scale 1, 2, 4, 6, and 24 hours after surgery. The use of xefocam in combination with microdose ketamine was ascertained to cause no increase in the frequency of adverse reactions, to upgrade the quality of analgesia, and to minimize the intensity of pain 24 hours following surgery.
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The paper discusses the theoretical background and practical rationale for a concept of pre-emptive analgesia. It gives the results of studying the efficacy of lornoxicam that outstrips the infliction of a surgical injury in different anesthesia modes (combined total and intravenous combined multicomponent anesthesia with epidural block). A hundred thirty-seven patients who had undergone laparoscopic cholecystectomies (Group 1) and expanded interventions for colorectal cancer (Group 2) were examined. The examination provided no evidence for the efficiency of pre-emptive analgesia with lornoxicam during perioperative anesthesia in patients undergone moderately and highly traumatic abdominal interventions.
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Anesteziol Reanimatol · Jul 2008
Randomized Controlled Trial[Role of paracetamol in a balanced postoperative analgesia scheme after thoracotomy].
The efficiency of paracetamol used in the balanced multimodal analgesia after thoracotomy still remains unclear. The prospective study covered 75 adult patients operated on the chest. The patients were randomized to 3 groups. ⋯ The high incidence of skin itch (20%) and urinary retention (8%) was observed in Group 3 (p < 0.017). No difference was found between the groups in the development of dyspepsia. The use of paracetamol in the postoperative multimodal analgesic therapy program after thoracotomy reduces the daily dose of epidurally administered ropivacaine and fentanyl with evident upgrade of analgesia quality, and the incidence of opioid-induced adverse reactions.