scholarly journals Epidural analgesia in patients with thrombocytopenia. Clinical case

2021 ◽  
Vol 14 (3) ◽  
pp. 164-170
Author(s):  
E. V. Goncharova ◽  
A. Y. Polushin ◽  
M. A. Kucher ◽  
M. V. Ermolova ◽  
Y. R. Zalyalov ◽  
...  
Keyword(s):  
Clinical Case ◽  
Pain Syndrome ◽  
B Cell Lymphoma ◽  
Multimodal Analgesia ◽  
Infectious Complications ◽  
Long Term Follow Up ◽  
Somatic Status ◽  
Diffuse B Cell Lymphoma ◽  
Inflammatory Drugs

The article presents a clinical case of a 25-year-old patient with progressive diffuse B-cell lymphoma with lesions of the S2 nerve root, accompanied by pain syndrome that is not relieved by systemic multimodal analgesia using opioids, antiepileptic and non-steroidal anti-inflammatory drugs. Polyneuropathy, secondary immunodeficiency, thrombocytopenia grade IV refractory to platelet concentrate transfusion, Guillain-Barre syndrome, impaired the somatic status and intensified the pain syndrome. Local anesthetics epidural port was successfully implanted to improve quality of analgesia. As a result of prolonged epidural infusion of 0.2% ropivacaine with titration rate from 4 to 7 ml/hour depending on the severity of the pain syndrome, that significantly improved patients quality of life was achieved by reducing the intensity of pain and increasing duration of night sleep. In the early postoperative and long-term follow-up periods (14 days), there were no hemorrhagic and infectious complications associated with the use of the epidural port.

scholarly journals Local use of Muscomed in the treatment of patients with knee osteoarthritis

TRAUMA ◽  
2021 ◽  
Vol 22 (2) ◽  
pp. 28-33
Author(s):  
A.V. Makogonchuk ◽  
Yu.O. Bezsmertnyi ◽  
L.Ye. Atamanchuk
Keyword(s):  
Analogue Scale ◽  
Pain Syndrome ◽  
Knee Joints ◽  
Osteoarthritis Of The Knee ◽  
Efficacy And Safety ◽  
Safety And Efficacy ◽  
Womac Index ◽  
Inflammatory Drugs ◽  
Local Use

The article presents the literature data and the results of our own investigation on the efficacy and safety of Muscomed cream in the treatment of patients with osteoarthritis of the knee joint. The study included 20 women (mean age 62 years). The study design included clinical and radiological examination of patients and survey using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the visual analogue scale at the beginning of treatment, on days 7 and 14 of using Muscomed cream. Muscomed cream was applied topically as a component of physiotherapeutic procedures as a part of a comprehensive conservative treatment. Two weeks after completing the course of treatment, there was a significant decrease in the intensity of pain syndrome and a decrease in the total WOMAC index in patients who used Muscomed cream locally. There was also a more pronounced decrease in the need for non-steroidal anti-inflammatory drugs in patients of the main group. The safety and efficacy of the Muscomed cream in the treatment of osteoarthritis of the knee joints were demonstrated, which resulted in a decrease in the severity of pain syndrome and an improvement in the functional activity and quality of life of such patients.

Long-term follow-up after cystectomy for bladder pain syndrome: Pain status, sexual function and quality of life

2019 ◽  
Vol 18 (1) ◽  
pp. e1977
Author(s):  
L. Mateu Arrom ◽  
C. Gutierrez Ruiz ◽  
O. Mayordomo ◽  
V. Martínez ◽  
J. Palou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sexual Function ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Pain Status ◽  
Long Term Follow Up

scholarly journals Myofascial pain syndrome: risk factors, diagnosis and local therapy

2020 ◽  
pp. 45-52
Author(s):  
V. V. Tsurko ◽  
E. O. Samokhina ◽  
N. V. Malysheva
Keyword(s):  
Myofascial Pain ◽  
Local Therapy ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Systemic Absorption ◽  
Affected Tissue ◽  
Inflammatory Drugs ◽  
Transdermal Penetration ◽  
Myofascial Syndrome

One of the main reasons for seeking medical help is myofascial syndrome (MFS), which is manifested by local inflammation with elements of degenerative changes in the affected tissue, pain and muscle spasm due to dysfunctional disorders in the nociceptive system and a decrease in the quality of life. This review discusses etiopathogenesis in detail, taking into account the factors predisposing to the development of MFS, which are divided into anatomical, ergonomic, medical and psychosocial, and also provides diagnostic criteria for pain MFS, including 5 large and 3 small criteria necessary for diagnosis. The second part of the review examines the indications, efficacy, safety, and benefits of topical forms of nonsteroidal anti-inflammatory drugs (NSAIDs), which have a moderate effect on pain, but have a much better safety profile due to reduced systemic absorption. The use of topical drugs allows you to create an effective concentration of the drug directly in the lesion and avoid undesirable systemic effects. Experts strongly recommend prescribing primarily topical, rather than oral, NSAIDs to patients aged 65 years and older who have concomitant cardiovascular and renal pathology, as well as diseases of the gastrointestinal tract. In more detail, the review examines topical forms of diclofenac, which differ in the maximum degree of transdermal penetration compared to other NSAIDs and the effect of slow release of the active substance into the surrounding tissues.

scholarly journals The effectiveness of non-steroidal anti-inflammatory drugs in the treatment of chronic pelvic pain syndrome

2018 ◽  
pp. 111-115
Author(s):  
T.G. Romanenko ◽  
◽  
O.M. Sulimenko ◽  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Antiplatelet Agents ◽  
Reproductive Age ◽  
Pelvic Pain Syndrome ◽  
Group I ◽  
Inflammatory Drugs

Evidence-based medicine is an approach to medical practice in which the decision on the appointment of therapeutic, diagnostic or preventive measures is based on the evidence of their effectiveness and safety. The objective: assessment of the effectiveness and safety of the use of NSAIDs in the treatment of chronic pelvic pain in women of reproductive age. Materials and methods. Under our supervision, there were 101 women of reproductive age with chronic pelvic pain syndrome (CPPS) on the background of chronic inflammatory processes of the pelvic organs. Patients, depending on the received treatment, were randomly divided into two groups: Group I (n=54) – complex antibiotic (AB) therapy was conducted in combination with antiplatelet agents, antihypoxants, analgesics; Group II (n=47) – complex antibiotic (AB) therapy was performed in combination with antiplatelet agents, antihypoxants and NSAIDs (DICLOSAFE, diclofenac sodium 100 mg). The exclusion criterion was the presence of an endometriosis in a patient. When patients were included in the study and 6 months after the completion of the treatment, a questionnaire was conducted to determine the severity of the pain syndrome, psychological status and quality of life. Results. Positive dynamics of quantitative and qualitative characteristics of the pain syndrome, as well as dynamics of its intensity as a result of conservative treatment for 6 months in group ІІ, was noted. Also, in group ІІ, statistically significant data on the reduction of depression and personal anxiety are noted, in contrast to the indicators of group I. The results of the questionnaire of patients in group II after treatment indicated improvement of all components of physical health. Statistically significant differences with the indicators of Group I were obtained on the scale of the effect of pain on daily activity (BP). In addition, after treatment in the II group, the patients showed statistically significant changes in mental health and all its components: vital activity (VT), social activity (SF), limitation of daily activity due to emotional problems (RE) and mental health I (MH). Conclusion. Pathogenetically grounded use of NSAIDs (DICLOSAFE suppositories) in the complex treatment of patients with CPPS allows to achieve a significant improvement in quality of life indicators due to the correction of pain syndrome. Key words: chronic pelvic pain syndrome, treatment, nonsteroidal anti-inflammatory drugs.

scholarly journals Clinical case of postoperative anesthesia of a patient by using subanesthetic dose of ketamine in severe abdominal pathology

Pain medicine ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 61-66
Author(s):  
B V Zaletskyi ◽  
V A Korobko ◽  
D V Dmytriiev
Keyword(s):  
Clinical Case ◽  
Opioid Analgesics ◽  
Topical Problem ◽  
Surgical Interventions ◽  
Stress Markers ◽  
Inflammatory Drugs ◽  
Positive Effect ◽  
Great Stress ◽  
Regional Anesthetic

Pain is an inevitable consequence of surgical interventions in children, resulting in great stress and discomfort not only for patients but also for their parents. The intensity of the pain depends not only on the level of injury after the operation, but also on the localization and the nature of the procedure. Management of pain in children is best done through a multimodal approach: opioids, auxiliary drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, anti-neuroleptics such as gabapentin, and regional anesthetic methods. Postoperative anesthesia in abdominal surgery at present is a topical problem in anesthetic practice. In this clinical case, we would like to demonstrate the experience of applying post-operative anesthesia using subnormal dosages of ketamine. The patient was given anesthesia with prolonged infusion of a ketamine solution in a submorbid dose of 0.2 mg/kg/h IV. An assessment of the quality of anesthesia by assessing the level of stress markers, such as blood glucose, cortisol levels, and the assessment of the pain level on the NIPS scale was performed. Conclusion: The use of a ketamine solution in a dose of 0.2 mg/kg/h has a positive effect on treating postoperative pain in patients after severe abdominal surgical interventions. Applying a ketamine solution in a dose of 0.2 mg/kg/h reduces tolerance of the patient to opioid analgesics and the development of hyperalgesia and allodynia.

scholarly journals Therapeutic niche of hyaluronic acid derivatives in osteoarthritis

2021 ◽  
pp. 123-132
Author(s):  
I. G. Krasivina ◽  
L. N. Dolgova ◽  
N. V. Dolgov
Keyword(s):  
Hyaluronic Acid ◽  
Pain Syndrome ◽  
Reduction Of Pain ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Viscoelastic Substances ◽  
Local Use ◽  
Point Of Intersection ◽  
Therapeutic Doses

Osteoarthritis (OA) is a widespread disease of synovial joints, the treatment of which determines a significant number of tactical and strategic directions. Currently, there is experience in the local use of so-called synovial fluid (SF) prostheses, which are viscoelastic substances that improve the cushioning properties of the native intra-articular environment. The overwhelming majority of viscoelastic additives are represented by hyaluronic acid (HA) derivatives, a natural component of SF, whose biological role consists in maintaining the rheological properties of fluid and the presence of anti-inflammatory, anti-nociceptive and chondro-protective properties. In the development of HA drugs, the main goals are the sustained and controlled release of therapeutic doses of the drug, taking into account the choice of carrier, drug molecule and target articular tissue. Assessing the quality and physiological feasibility of introducing a particular viscoelastic drug into the joint involves determining the so-called crossover frequency - the point of intersection of the viscosity modulus G’ and the elastic modulus G” (G’/G”), which reflects changes in the viscoelastic properties of the SF with increasing load frequency when transitioning from walking to running. Physiological range of frequencies out of the majority of investigated medical products corresponds to a single one, among which there are also variants of domestic production. Numerous studies of local application of some HA drugs in patients with OA confirm their effectiveness and safety, in particular, reduction of pain syndrome, reduction of the need for nonsteroidal anti-inflammatory drugs, improvement of the quality of life. However, unfortunately, most HA drugs available on the market have not undergone full-fledged clinical trials, so there is a need to study the comparative effectiveness of drugs of this group approved for use and determine their place in the treatment of OA with different variants of the course.

Long-term follow-up after cystectomy for bladder pain syndrome: pain status, sexual function and quality of life

2018 ◽  
Vol 37 (8) ◽  
pp. 1597-1603 ◽  
Author(s):  
Laura Mateu Arrom ◽  
Cristina Gutiérrez Ruiz ◽  
Olga Mayordomo Ferrer ◽  
Virginia Martínez Barea ◽  
Joan Palou Redorta ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sexual Function ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Pain Status ◽  
Long Term Follow Up

Which NSAID to choose for treatment of pain syndrome in polymorbid patients?

2021 ◽  
pp. 41-46
Author(s):  
A. P. Pereverzev
Keyword(s):  
Chronic Pain ◽  
Odds Ratio ◽  
Pain Syndrome ◽  
Moderate Pain ◽  
Efficacy And Safety ◽  
First Line ◽  
Increased Risk ◽  
Inflammatory Drugs ◽  
First Line Treatment

A polymorbid patient is a patient with several diseases occurring simultaneously at different stages and phases of their development. Patients with polymorbid pathology have a statistically significant almost 2.5 times higher risk (odds ratio [OR] = 2.41; p = 0.01) of pain syndrome and other diseases (for example, depression, arterial hypertension, etc.), which will contribute to the progression of polymorbidity. Individuals with chronic pain have a significantly increased risk of all causes’ death (hazard ratio [HR] = 1.95; 95 % confidence interval [CI]: 1.26–3.03) and cardiovascular causes (RR = 2.72; 95 % CI: 1.41–5.26) compared to patients without chronic pain. Therefore, in order to improve the prognosis and quality of life of the patient, both acute and chronic pain must be treated with non-pharmacological (exercise therapy, taping, virtual reality, etc.) and pharmacological methods. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for mild to moderate pain. The rational choice of NSAIDs in polymorbid patients can be difficult due to the presence of pathologies that limit their use or conditions that are risk factors of complications of drug therapy. In this article, the author present approaches to choosing the optimal NSAID in polymorbid patients, and justify efficacy and safety of administration of original meloxicam in these individuals (Movalis®, Boehringer Ingelheim International).

scholarly journals Nefopam hydrochloride as a component of multimodal analgesia in the postoperative period

Pain medicine ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 68-75
Author(s):  
Andrii Semenenko
Keyword(s):  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Multimodal Analgesia ◽  
Early Postoperative Period ◽  
Modern Approach ◽  
Surgical Interventions ◽  
Reduction Of Pain ◽  
Effective Drugs

The modern approach to the multimodal scheme of postoperative analgesia includes the mandatory use of drugs that have a small number of side effects and at the same time have a polymodal effect on the pathogenetic links of pain development. Nefopam hydrochloride is able to prevent the development of: opioid hyperalgesia, stop pain stimuli without respiratory depression, affect platelet aggregation and the condition of the mucous membrane and motility of the gastrointestinal tract, which distinguishes it from classical NSAIDs. Nefopam hydrochloride is characterized by a low risk of addiction with prolonged use, a pronounced anti-sensory effect, especially significant at the stage of awakening and in the early postoperative period. Postoperative analgesia based on nefopam hydrochloride as a component of multimodal analgesia is effective and safe in the absence of absolute contraindications. The planned use of nefopam hydrochloride for the correction of pain reduces complications in the postoperative period and improves the quality of life of patients. Nefopam hydrochloride is one of the most effective drugs for the correction of postoperative tremor syndrome. The use of nefopam hydrochloride as a drug, which is a part of premedication before surgical interventions and a component of multimodal analgesia, improves the quality of the postoperative period due to: reduction of pain syndrome, planned correction of postoperative tremor syndrome and correction of complications arising from inadequate treatment of pain syndrome.

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