Objective. The aim of the work was to assessment the analgesic effect of dexamethasone at peripheral nerve blockades. Material and methods. The study included 166 patients, including 45 children aged from 3 to 16 years of age, randomized into 3 groups. For blockages in peripheral nerves of the 1st group received 0.5% solution ropivacine, in the 2 nd group - 0.5% solution ropivacine and dexamethasone intravenous, 3 rd group - 0.5% solution ropivacine and dexamethasone. Results. Duration period painless adults was 12.8±7.1 h, 22.8±4.8 h and 24,1±6,8 h, children 8.3±1.5 h, 10.4±1.7 h and 20±5 h, respectively. It is shown that the use of dexamethasone protects the patient from nociceptive afferentation in the postoperative period. Possible mechanisms of the analgesic effect of dexamethasone was discussed. Conclusion. Further research is needed to study the mechanism of analgesic action of dexamethasone.

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Multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a life-threatening condition that often requires intensive care unit (ICU) admission. The aim of this study was to determine risk factors for severe/life-threatening course of MIS-C. The study included 166 patients (99 boys, 67 girls) aged 4 months–17 years (median 8.2 years). The criterion of severity was the fact of ICU admission. To conduct a comparative analysis, MIS-C patients were divided into two groups: patients hospitalized in the ICU (n = 84, 50.6%) and those who did not need ICU admission (n = 82, 49.4%). Patients with a more severe course of MIS-C were significantly older. They had a higher frequency of signs such as rash, swelling, hepatomegaly, splenomegaly, and neurological and respiratory symptoms. Hypotension/shock and myocardial involvement were much more common in patients with severe MIS-C. These patients had a more significant increase in CRP, creatinine, troponin, and D-dimer levels. Additionally, the presence of macrophage activation syndrome was higher in patients admitted to the ICU. Conclusion: Nineteen predictors of severe course of MIS-C were found, out of which hepatomegaly, splenomegaly, D-dimer > 2568 ng/mL, troponin > 10 pg/mL were mainly associated with the probability of being classified as early predictors of severe MIS-C requiring ICU admission.

A clinical case of mitochondrial neurogastrointestinal encephalopathy (MNGIE), a rare autosomal recessive multisystem disease caused by TYMP gene mutations and thymidine phosphorylase (TP) deficiency, is presented. Authors draw the specialists’ attention to the complexity of making a diagnosis and the importance of an interdisciplinary approach in the diagnosis and management of such patients with the purpose of increasing the pediatric practitioners’ MNGIE awareness thereby reducing the time to diagnosis, which in its turn improves the prognosis for the course of the disease for the patients.

Objective. To assess the effect of infusion of lidocaine solution in patients after extensive abdominal operations. Material and methods. Were examined 42 patients with cancer of the pancreas, which is made pancreatoduodenal resections. The patients were divided into two comparable groups. Patients of the first group (n=21) before surgery injected bolus 1.5 mg/kg lidocaine, followed by infusion at a rate of 1.5 mg/kg*h during the first 24 hours after surgery. Patients of the second group (n=21) started epidural infusion of 0.2 % ropivacaine solution at a rate of 5 ml/h. The intensity of pain syndrome was evaluated on VAS at rest and during mobilization, bowel actions, the time of first flatus and first stool, the need for additional analgesics and lenght of stay in the intensive care unit. Results. The intensity of pain in the first day was significantly (p