The analysis of effectiveness of isolated and combined prescription of non-opioid analgesics and adjutants during different surgery


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The paper presents the results of clinical study conduced in order to compare the effectiveness of different non-opioid analgesics and adjuvants affecting the NMDA-receptors and applied for prophylaxis and management of acute postoperative pain. The study includes 347 patients undergone appendectomy, inguinal hernia repair, laparoscopic cholecystectomy. It was show that some non-opioid analgesics (NSAIDs) and adjuvans (ketamine, gabapentin) reduce pain intensity and opioid analgesics consumption for some surgical manipulations and are not effective for the other surgery. Complex prescription of NSAIDs, ketamine and gabapentin significantly reduces intensity of postoperative pain in all conditions and allows refusing from using of opioid analgesics.

作者简介

I. Efremenko

FSBI “Ryazan’ City Clinical Hospital of Emergency Medicine”

390013, Ryazan’

Alexei Ovechkin

SBEI “Sechenov First Moscow State Medical University” of MHC of RF

Email: ovechkin_alexei@mail.ru
119991, Moscow

M. Krasnoselskiy

SBEI “Sechenov First Moscow State Medical University” of MHC of RF

119991, Moscow

参考

  1. Gerbeshagen H., Aduckathil S., Van Wijck A., Peelen L., Kalkman C., Meissner W. Pain intensity on the first day after surgery. Anesthesiology. 2013; 118: 934-944.
  2. Oderda G., Evans S., Lloyd J. Cost of opioid-related adverse drug events in surgical patients. J. Pain Symptom Manage. 2003; 25: 276-283.
  3. Chia Y., Liu K., Wang J. Intraoperaive high dose fentanyl induces postoperative fentanyl tolerance. Can. J. Anaesth. 1999; 46: 872-877.
  4. Xuerong Y., Yuguang H., Xia Y. Ketamine and lornoxicam for preventing a fentanyl-induced increase in postoperative morphine requirement. Anesth.Analg. 2008; 107: 2032-2037.
  5. Gottschalk A., Sharma S., Ford J. The role of the perioperative period in recurrence after cancer surgery. Anesth. Analg. 2010; 110: 1636-1643.
  6. Wheeler M., Oderda G., Ashburn M. Adverse events associated with postoperative opiod analgesia: a systemic review. J.Pain. 2002; 3: 159-180.
  7. Маячкин Р.Б. Неопиоидные анальгетики в терапии боли после обширных хирургических вмешательств: Дисс. ...канд. мед. наук, М., 2006.
  8. Kehlet H. Labat lecture 2005: surgical stress and postoperative outcome - from here to where? Reg. Anesth. Pain Med. 2006; 31: 47-52.
  9. Овечкин А.М. Неопиоидная фармакотерапия острой послеоперационной боли. В кн.: Анестезиология и интенсивная терапия: 21 взгляд на проблемы XXI века. М.: Бином; 2011: 90-107.
  10. Гельфанд Б.Р., Кириенко П.А. Сравнительная оценка эффективности нестероидных противовоспалительных препаратов, применяемых для послеоперационного обезболивания. Вестник интенсивной терапии. 2002; 4: 1-5.
  11. Ежевская А.А. Прусакова Ж.Б., Загреков В.И., Овечкин А.М. Влияние инфузии сульфата магния в сочетании с блокадой поясничного сплетения и внутримышечным введением кеторолака на течение послеоперационного периода у пожилых больных после операций на тазобедренном суставе. Регионарная анестезия и лечение острой боли. 2012; 1: 15-20.
  12. Launo C., Bassi C., Spagnolo L. Preemptive ketamine during general anesthesia for postoperative analgesia in patients undergoing laparoscopic cholecystectomy. Minerva Anesthesiol. 2004; 70: 727-738.
  13. Turan A., White P., Karamanlioglu B. Gabapentin: an alternative to the cyclooxigenase-2 inhibitors for perioperative pain management. Аnesth.Analg. 2006; 102: 175-181.
  14. Urban M., Ya Deau J., Wukovits B. Ketamine as an adjunct to postoperative pain management in opioid tolerant patients after spinal fusions: a prospective randomized trial. HSSJ. 2008; 4: 62-65.
  15. Овечкин А.М. Профилактика послеоперационного болевого синдрома. Патогенетические основы и клиническое применение. Автореф. дисс. … д-ра мед.наук. М., 2000.
  16. De Kock M., Lavand’homme P., Waterloos H. Balanced analgesia in the perioperative period: is there place for ketamine? Pain. 2001; 92: 373-380.
  17. Haroutiunian S., Nikolajsen L., Finnerup N. The neuropathic component in persistent postsurgical pain: a systematic literature review. Pain. 2013; 154: 95-102.
  18. Tramer M., Schneider J., Marti R., Rifat K. Role of magnesium sulfate in postoperative analgesia. Anesthesiology. 1996; 84: 340-347.
  19. Koinig H., Wallner T., Marhofer P. Magnesium sulfate reduces intra- and postoperative analgesic requirements. Anesth. Analg. 2004; 87: 206-210.
  20. Nowak L., Bregestovski P., Ascher P. Magnesium gates glutamate-activated channels in mouse central neurones. Nature 1984; 307: 462-465.
  21. Weissberg N., Schwartz G., Shemesh O. Serum and intracellular electrolytes in patients with and without pain. Magnes. Res. 1991; 4: 49-50.
  22. Sanchez-Capuchino A., McConachie I. Perioperative effect of major gastroinestinal surgery on serum magnesium. Anaesthesia. 1994; 49: 912-914.
  23. Clivatti J., Sakata R., Issy A. Review of the use of gabapentin in the control of postoperative pain. Rev.Bras.Anesthesiol. 2009; 59: 87-98.

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