scholarly journals A contemporary approach to sedation during regional anaesthesia in gynaecology

Pain medicine ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 52-56
Author(s):  
Yevhenii Grizhimalsky ◽  
Andrii Harha
Keyword(s):  
Postoperative Period ◽  
Regional Anaesthesia ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Slow Recovery ◽  
Basic Principles ◽  
Current Time ◽  
Adequate Sedation ◽  
Effective Sedation ◽  
Contemporary Approach

Safe and adequate sedation during regional anesthesia is one of the issues at the current time. According to the basic principles of modern anesthesiology, safe and effective sedation should protect the patient’s psycho-emotional sphere, provide absence of awareness, pain and fear during surgery as well as nausea and vomiting in the postoperative period. At the same time, it should neither cause respiratory depression and haemodynamics changes, nor be accompanied by a slow recovery of psychomotor function.After studying modern literature and analyzing our own observations, we reached the point that sedation with dexmedetomidine rather than propofol is more preferred during regional anaesthesia. Sedation with dexmedetomidine decreases frequency of cognitive impairment in the early postoperative period, intensity of the pain syndrome, and has beneficial effect on recovery and activation after surgery. Additionally, it is associated with lower risk of hypoxemia and arterial hypotension during surgery.

scholarly journals Choice of surgical treatment for chronic composite hemorrhoid

2020 ◽  
Vol 39 (3) ◽  
pp. 27-31
Author(s):  
Oleg A. Litvinov ◽  
Evgeniy V. Zhitikhin ◽  
Igor G. Ignatovich ◽  
Hovannes A. Arutyunyan ◽  
Artur G. Arustamov ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Rating Scale ◽  
Stage Iv ◽  
Pain Syndrome ◽  
Numeric Rating Scale ◽  
Early Postoperative Period ◽  
Control Group ◽  
Scientific Center ◽  
Cavernous Tissue ◽  
Numeric Rating

A comparative analysis of the treatment of 142 patients operated on chronic hemorrhoid stage IIIIV has been passed by way of assess the results of using new version of hemorrhoidectomy. The age of patients ranged from 27 to 80 (mean age was 50.46.7). 86 (60.6%) patients were diagnosed with stage III chronic hemorrhoid, at 56 (39.4%) patients the stage IV. For this study patients were divided into basic and controlled groups. The basic group consisted of 73 (51.4%) patients that have had hemorrhoidectomy using our modification. There were 69 (48.6%) patients in control group that have been operated by MilliganMorgan method in second modify of State Scientific Center of Proctology using bipolar coagulator LigaSure. The level of pain was assessed in the early postoperative period by numeric rating scale. The patients had been operated by our method mentioned that the pain syndrome was less pronounced (3.2 against 4.9 balls), that required less painkillers in the early postoperative period. In the case of doing semicircle cuts on the border of anocutaneous crinkle and bringing down mucous membrane, the significant excision of the cavernous tissue doesnt lead to contraction of the anal canal by that reduces the number of functional disorders after hemorrhoidectomy (4 figs, 1 table, bibliography: 7 refs).

scholarly journals Photobiomodulation of acute pain syndrome after septoplasty

2021 ◽  
Vol 10 (2) ◽  
pp. 34-41
Author(s):  
I. V. Kastyro ◽  
Yu. S. Romanko ◽  
G. M. Muradov ◽  
V. I. Popadyuk ◽  
I. K. Kalmykov ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Acute Pain ◽  
Postoperative Period ◽  
Low Frequency ◽  
Pain Syndrome ◽  
Frequency Component ◽  
Early Postoperative Period ◽  
Total Power ◽  
Laser Exposure

The paper evaluates the effectiveness of the use of therapeutic laser exposure (photobiomodulation therapy – PBMT) to minimize acute pain in the early postoperative period in patients after septoplasty. The study included two groups of patients. Patients of the first group (31 patients) underwent septoplasty with standard management in the postoperative period. Patients of the second group (31 patients) also underwent septoplasty, and then added PBMT to the standard measures of the postoperative period at 3, 6 and 24 h after septoplasty (λ = 0.890 μm, P = 10 W, 2 min) and then intranasally 48 h after septoplasty (λ = 0.630 μm, P = 8 W, 2 min). In patients of both groups, heart rate variability and pain were assessed using a visual analog scale within 48 hours after septoplasty. In patients of the second group, after the use of PBMT, the indicators of heart rate variability had a significantly lower total power, compared with patients of the first group. So, after PBMT, the ultra-low-frequency component of the spectral analysis of heart rate variability in the first group was 18580 ± 2067 ms2, which is significantly higher than in the second group (8086 ± 3003 ms2) (p <0.001). The low-frequency component of heart rate variability was also significantly higher in the first group (1871 ± 405 ms2) compared to the second (1095 ± 190 ms2) (p <0.005), which indicates an increase in the tension of the sympathetic part of the autonomic nervous system in the group without the use of PBMT. In the first 3 hours after surgery, the severity of pain between the groups did not differ significantly (p = 0.07). In the period from 6 to 24 hours after surgery, patients who did not undergo PBMT experienced significantly higher pain than patients with PBMT (p <0.001). Thus, in our study, the group of patients with PBMT showed better results in pain and heart rate variability compared to the classical rehabilitation of patients after septoplasty.

scholarly journals Protocol of intravenous lidocaine infusion in the postoperative period in children operated on abdominal organs

2021 ◽  
Vol 15 (1) ◽  
pp. 41-47
Author(s):  
Evgeny Y. Felker ◽  
Dmitry V. Zabolotskii
Keyword(s):  
Postoperative Period ◽  
Pediatric Anesthesia ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Standards Of Care ◽  
World Federation ◽  
Intravenous Lidocaine ◽  
Surgical Interventions ◽  
Perioperative Analgesia ◽  
Abdominal Organs

BACKGROUND: Many studies indicate the effectiveness of intravenous lidocaine infusion for perioperative analgesia and treatment of intestinal paresis in adults. In the scientific literature, only a few publications focus on the intravenous infusion of lidocaine in pediatric practice. The purpose of the work is to increase the effectiveness of the treatment of pain syndrome after operations on abdominal organs in children by creating a protocol for intravenous lidocaine infusion. MATERIALS AND METHODS: In the development of the clinical protocol, publications included in the databases PubMed, Cochrane, American Society of Anesthesiologists, World Federation of Pediatric Intensive and Critical Care Societies, and American Academy of Pediatrics were considered. The recommendations and standards of care for this problem from the Committee on Pediatric Anesthesiology (Statement on Practice Recommendations for Pediatric Anesthesia, 2016), Society for Paediatric Anesthesia Anaesthesiology, and our own materials for our research performed at the St. Petersburg State Pediatric Medical University. RESULTS: The developed protocol includes 11 provisions, including indications and contraindications to the use of lidocaine infusion, preoperative examination, a list of necessary equipment, the method of infusion, methods of evaluation, and control of postoperative pain syndrome. CONCLUSIONS: A protocol for the management of children in the early postoperative period using intravenous lidocaine infusion, as an alternative to prolonged epidural blockade and systemic anesthesia, is developed. The authors express confidence that further implementation of the protocol in clinical practice will improve the quality of medical care for children after abdominal surgical interventions.

scholarly journals THE APPLICATION OF MAGNETIC FIELDS AND FLUCTUORIZATION IN THE EARLY POSTOPERATIVE PERIOD IN PATIENTS AFTER RADICAL MASTECTOMY

2019 ◽  
Vol 6 (3) ◽  
pp. 157-162
Author(s):  
Marina Yu. Gerasimenko ◽  
Inna S. Evstigneyeva ◽  
O. M Perfil’yeva ◽  
L. V Tumbinskaya
Keyword(s):  
Postoperative Period ◽  
Radical Mastectomy ◽  
Pain Syndrome ◽  
Shoulder Girdle ◽  
Early Postoperative Period ◽  
Physical Factors ◽  
Operative Interference ◽  
Group 2 ◽  
Magnetic Therapy

We conducted an objective and instrumental examination in 76 patients with radical mastectomy in the early postoperative period (2-4 days), after which the patients of the 1st group (n = 38) underwent a course of fluctuation of the muscles of the shoulder girdle and upper extremity from the side of operative interference without interruption. Group 2 (n = 38) after the course, the course of fluctuation of the muscles of the shoulder girdle and upper limb from the side of operative interference without interruption was carried out extended low-intensity magnetic therapy of the postoperative area and arm. It has been proved that with this combination, the patient notes an improvement in the quality of life, postoperative swelling decreases, pain syndrome decreases, lymphorrhea periods shorten. As a result of the study, the number of postoperative complications in the wound area decreased (inflammation, infectious processes, pain, seam divergence). There is an increase in the amount and quality of movements, reduced sensitivity disorders in the upper limbs. The results of remote infrared thermography showed that the positive dynamics remained only in patients from both groups who received the combined use of two factors, which proves the prolongation of the clinical effect. Thus, the combination of two physical factors in the early postoperative period, in patients after radical mastectomy, has broad functionality and allows to obtain a more pronounced and stable clinical result.

Features of expeditious treatment of gynecologic diseases laparotomic and laparoscopic accesses at women with extragenital pathology

2017 ◽  
pp. 111-114
Author(s):  
V.V. Kostikov ◽  
Keyword(s):  
Cardiovascular Diseases ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Abdominal Pressure ◽  
Short Term ◽  
Comparison Results ◽  
Pulmonary Pathology ◽  
Definition Of ◽  
Gynecologic Patients

The objective: definition of optimum access of an operative measure at gynecologic patients with extragenital pathology. Patients and methods. Were included in research of 240 patients who were on treatment inhospital and operated concerning diseases of internal genitalias laparotomic and laparoscopic accesses. All patients had an extragenital pathology. Depending on operation access all patients were divided into two groups. The main group was made by 120 patients operated with laparoscopic access. 120 patients operated with laparotomic access, made group of comparison. Results. Results of the conducted researches testify that at gynecologic patients with cardiovascular, broncho-pulmonary pathology, an obesity and a diabetes mellitus preferable quick access it is necessary to consider laparoscopy. Operation by laparoscopic access at patients with cardiovascular diseases is accompanied short-term (till 5 minutes) by deterioration of indicators of a hemodynamic at the time of rising of intra abdominal pressure and creation of provision of Trendelenburga. The specified changes quickly are normalized and remain stable throughout operation and in the early postoperative period. Laparotomic access leads to more expressed and long deterioration of hemodynamic indicators at patients with cardiovascular diseases during operation and in the early postoperative period. Laparoscopic operations at patients with extragenital pathology are less enduring, minimum traumatic, are accompanied by small hemorrhage. At the patients operated with laparoscopic access, the pain syndrome, disturbances of function of an intestine is less expressed, a physical activity is quickly restored, terms of stay in hospital and after treatment terms are reduced. Conclusion. At gynecologic patients with the compensated extragenital pathology can be given preference to laparoscopic access of an operative measure. Key words: gynecologic operations, laparotomy, laparoscopy.

scholarly journals ASSESSMENT OF THE INTENSITY OF PAIN SYNDROME AND COLLATERAL SWELLING DURING THE SOCKET AUGMENTATION AFTER TOOTH EXTRAXTION WITH DIFFERENT OSTEOPLASTIC MATERIALS

2021 ◽  
Vol 21 (2) ◽  
pp. 97-102
Author(s):  
A. V. Bambuliak ◽  
N. B. Kuzniak ◽  
R. R. Dmytrenko ◽  
S. V. Tkachyk ◽  
V. A. Honcharenko
Keyword(s):  
Comparative Analysis ◽  
Postoperative Period ◽  
Tooth Extraction ◽  
Rating Scale ◽  
Alveolar Bone ◽  
Numerical Rating Scale ◽  
Blood Clot ◽  
Pain Syndrome ◽  
Clinical Effectiveness ◽  
Early Postoperative Period

The article presents a comparative analysis of the clinical effectiveness of osteoplastic materials, in particular a preparation based on multipotent mesenchymal stromal cells of adipose tissue and platelet-enriched plasma used to fill bone defects during the socket augmentation after the tooth extraction. The criteria to assess the therapy effectiveness at the stage of the early postoperative period included the intensity of pain and the amount of collateral oedema after surgery. The aim of this study is to evaluate the clinical effectiveness of osteoplastic materials to augment the volume of the alveolar bone during the operation of socket augmentation after the tooth extraction. Setting of this study: Bukovynian State Medical University, Chernivtsi, Ukraine. The study included 85 patients. The procedure of socket augmentation was performed by using "Kolapan - L" (28.57% of individuals, subgroup A), by combinations of MMSK AT + "Kolapan - L" + PRP (46.43% of individuals, subgroup B); the subgroup C included individuals (25.0%) whose wounds after tooth extraction healed by the formation a blood clot. The assessment of postoperative pain was performed by applying the digital rating scale (Numerical Rating Scale, NRS), taking into account the subjective pain in the patients. The subjects underwent visual assessment of the severity of collateral oedema after the tooth extraction surgery. To determine the dynamics of the severity of oedema we used a scoring system. The study demonstrated the patients of the subgroup B, who received the socket augmentation with "Kolapan - L" + MMSC-AT + PRP, experienced no pain at the final stage of postoperative observation (89.31% of cases) that was 1.2 times higher (p1 <0.05) than in the patients of subgroup A (p> 0, 05). At the final postoperative stages, no collateral oedema was seen in 98.47% of the participants of the subgroups B that exceed the number of cases in the subgroup A where the bone defect was augmented by "Kolapan - L", in 1.2 times (p1 <0.05). A comparative analysis of the clinical effectiveness of osteoplastic materials to increase the volume of the alveolar bone in the jaws during the socket augmentation after the extracted tooth convincingly proved the advantage of using the combination of "Kolapan - L" + MMSС - AT + PRP that was also confirmed by signs and symptoms in the postoperative period.

scholarly journals Experience with the dexmedetomidine for sedation in pediatric neurosurgery in the early postoperative period

2020 ◽  
Vol 33 (3) ◽  
pp. 56-65
Author(s):  
L.V. Havrylova
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Respiratory Depression ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Neurosurgical Department ◽  
Arterial Blood ◽  
Vital Functions ◽  
Adequate Sedation ◽  
Intensive Observation

Objective ‒ to maintain the adequate sedation and analgesia without respiratory depression in children up to 4 years old with spinal cord pathology in early postoperative period (first 3 days) in inpatient department; to decrease digestive system motor function depression; to exclude aspiration possibility; to start early children’s natural feeding in postoperative period.Materials and methods. From October 2019 to January 2020 dexmedetomidine sedation was performed by the prolonged infusion administration to 10 children (6 children aged 6 month to 1 year and 4 children up to 4 years) with spinal cord and vertebral pathology (spina bifida, meningomyelocele, myelocele, teratoma, lipoma of lumbar spine) in early postoperative period at intensive observation ward of neurosurgical department. During the first three days after the surgery and dexmedetomidine prescription the vital functions monitoring was being performed for 24 hours. Arterial blood pressure, heart rate, blood saturation have been scheduled by one of the parents. The immediate access to oxygen and parent’s permission for using this sedation method were the obligatory requirements.Results. The appropriate sedation target was achieved after the dexmedetomidine prescription for the children with the spinal cord and vertebral pathology in early postoperative period at intensive observation ward of neurosurgical department; the dosage of opioid analgesics was successfully decreased by 50 %. The respiratory depression was not observed. The blood pressure and bradycardia were not haemodynamically significant. Swallowing reflex was saved, which led to early physiological nutrition and excluded aspiration risk. The following transfer of patients after the surgery to the neurosurgical department bypassing ICU reduced the financial expenditure of the hospital.Conclusions. Dexmedetomidine provides with the adequate sedation in early postoperative period and can be recommended for the usage in children with the spinal cord and vertebral pathology as the safest medication due to minimal cardio-respiratory complications during moderately prolonged prescribed period.

scholarly journals Comparative analysis of the results of computerized phonoenterography in patients with acute destructive appendicitis before surgery and in the postoperative period

2017 ◽  
Vol 25 (3) ◽  
pp. 469-475
Author(s):  
K. V. Philippova ◽  
O. V. Zaitsev
Keyword(s):  
Abdominal Pain ◽  
Comparative Analysis ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Spectral Power ◽  
Abdominal Cavity ◽  
Pain Syndrome ◽  
Acoustic Signals ◽  
Early Postoperative Period ◽  
Control Group

Using the method of computerized phonoenterography we made an analysis of motor-evacuation function of the gastrointestinal tract in 35 patients with acute destructive appendicitis before surgery and in the postoperative period and in 30 patients without abdominal pain syndrome and concomitant pathology of the organs of the abdominal cavity. The obtained results of computerized phonoenterography different in the group of patients with acute appendicitis before appendectomy in comparison with group of patients without acute abdominal pathology (control group). For patients after appendectomy statistically significant differences with the control group in the vast majority of bands wasn’t obtained. Given the fact that the densities of the spectral power of acoustic signals of the abdominal cavity to assess the motor-evacuation function of the intestine in these groups of patients, we showed a reduction of motor-evacuation function of the intestine in patients with acute destructive appendicitis before surgery in comparison with patients of control group and recover in the postoperative period. Thus, the method of computerized phonoenterography is advisable to apply for the diagnosis of lower motor function of the intestine in patients with acute appendicitis, and in the early postoperative period in patients with acute destructive appendicitis for monitoring recovery of intestinal motility.

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