Adequate analgesia determines the success of the performed surgical intervention. In modern surgery, most of postoperative complications are directly related to ineffective therapy of pain syndrome in the perioperative period. The main principle of modern analgesia is its multicomponence, when analgesia, neurovegetative blockade and relaxation are achieved and potentiated by different drugs and methods. The blockade of nociceptive impulses with a local anesthetic at the transmission stage provides effective, targeted analgesia, hyporefl exia and muscle relaxation, prevents the sensitization of neuroaxial structures, hyperalgesia and the development of postoperative chronic pain syndrome. At the same time, providing analgesia with drugs of central action leads to the ineffectiveness of therapy in 80 % of cases, which has serious consequences.The aim. According to the literature review, to evaluate the effectiveness and safety of peripheral blockades on the example of performing a blockade of the pterygopalatine ganglion.Conclusion. The pterygopalatine blockade has broad indications for use in ophthalmology, which is explained by the complex structure of the pterygopalatine ganglion and the possibility of simultaneous infl uence on sympathetic, parasympathetic and nociceptive innervation. All the presented methods of pterygopalatine blockade performance have their advantages and disadvantages. Ultrasound navigation eliminates technical difficulties and the possibility of damage of the pterygopalatine fossa anatomical structures, ensuring the effectiveness and safety of the pterygopalatine blockade.
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.
This review presents the current state of postoperative pain in children. Based on the fundamental studies that have shown the presence of a newborn neurophysiological and neurochemical nociceptive information transmission mechanisms, provides information about the negative impact of pain on the body of the child. Presented neurophysiological aspects of pain perception in children, pain assessment methods, the basic principles of modern post-operative analgesia. Particular attention is given to drugs permitted for use in the Russian Federation. in children
Clinical guideline contained a summary on the management of hip fractures in the elderly. Presents the key positions, the implementation of which is required in the perioperative period. Special attention is given pain relief, prevention of delirium and management of patients in the postoperative period.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.