[Selection of components and methods for postoperative analgesia after extensive abdominal surgeries].
The modern technique of postoperative analgesia after extensive and traumatic surgical interventions presupposes the administration, apart from opiates, a variety of preparations inhibiting the biological activity of substances (prostaglandins, kinins, TNF, leukotrienes, etc.), i.e. mediators of the systemic-inflammatory response, which are of the key importance in modeling the postoperative pain. The paper deals with the specificity of postoperative analgesia at different stages of surgical treatment of patients with destructive pancreatitis (DP). The surgical tactics in DP envisages a primary revision of the abdominal cavity, necrectomy and omentobursostomy with subsequent multi ple stage-based sanations of the abdominal cavity. The above surgical technique in DP is traumatic and long-lasting with the in-hospital treatment amounting on the average to 46.8 +/- 3.2 days. The entire postoperative period in DP patients is divided into 4 stages with each stage having a certain specific level of intoxication, systemic-inflammatory response and of pain syndrome. An analgesia scheme, based on epidural anesthesia combined with the inhibitors of kinin-genesis (inhitril, contrical) of prostaglandin-genesis (ketorol of xefocam) and of a synthetic analogue of leu-enkephalines (daralgin). A specific combination of analgetics was typical of each treatment stage.
Sviridov
S V
SV
Butkevich
A Ts
ATs
Rychkova
S V
SV
Bocharov
V A
VA
Bakushin
V S
VS
El'shanskiĭ
I V
IV
Smol'tsov
E Iu
EIu
Shvartsev
A O
AO
Khovalyg
V T
VT
D034841:Abdominal Cavity / Q000601:surgery*; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D019283:Pancreatitis, Acute Necrotizing / Q000601:surgery*; D011480:Protease Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use
D000700:Analgesics; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D011480:Protease Inhibitors