Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Sep 1998
Comparative Study[Parenteral use of oruvel (ketoprofen) for analgesia in the postoperative period].
Antiinflammatory and analgesic effects of oruvel (ketoprofene), a nonsteroid antiinflammatory drug, are demonstrated by many scientists. Both intramuscular and oral oruvel is acknowledged as an effective means for therapy of inflammatory and dystrophic rheumatic diseases. Moreover, oruvel in 100-mg flasks for infusions is intended for the treatment of postoperative pain, specifically, in orthopaedic surgery.
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Anesteziol Reanimatol · Sep 1998
Review Comparative Study[Antinociceptive components of general anesthesia and postoperative analgesia].
The philosophy of full-value antinociceptive protection of patients during and after surgical interventions is discussed. The author presents her viewpoint on the problem with due consideration for recent published reports. She advocates a prophylactic approach to attaining the antinociceptive protection (the so-called "preemptive analgesia"). ⋯ For preventing secondary (central) hyperalgesia and decreasing the intensity of postoperative painful syndrome, NMDA-receptor antagonist ketamine in microdoses is recommended before and during surgery. Afferent nociceptive flow can be decreased by local and regional anesthesia. Practical application of the preemptive analgesia principle improves the efficacy and safety of analgesia at different stages of surgical treatment, decreases total and local (at the level of operated tissues) consequences of surgical trauma, and decreases the probability of complications.
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Anesteziol Reanimatol · Sep 1998
Review Comparative Study[Analgesic agents: comparative evaluation, mechanisms of action, prospects].
A classification of analgesics based on the localization and mechanisms of their action is proposed. Opioid analgesics are compared: opioid receptor agonists, agonists-antagonists, and partial agonists. Central-action nonopioid analgesics are listed: alpha 2-adrenomimetics, Na- and K-channel blockers, reverse monoamine neuronal capture inhibitors, stimulating amino acid antagonists, etc. Peripheral-action analgesics (cycloxygenase inhibitors) are described.
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Anesteziol Reanimatol · Sep 1998
Comparative Study[Prospects of the use of caudal epidural anesthesia].
Caudal epidural anesthesia for interventions on the lower limbs and pelvic organs was used in 525 patients. A specific feature of the method is use of hypoosmolic local anesthetic solution (osmolality 260 mosmol/kg) containing lidocaine, 0.9% sodium chloride, and distilled water. Pathologic studies showed that in adult patients, at least 40 ml anesthetic should be injected into the caudal canal for adequate blocking. ⋯ The duration of analgesic effect was 3 +/- 0.5 h and even longer, if local anesthesia was potentiated with sedative drugs. No complications were observed, failures occurred in 5.2% cases. The method is simple and reliable and is recommended for practice.