Pain medicine 2018-09-08T17:27:05+03:00 Oleksandr Marchuk Open Journal Systems <p>"Medicina bolu" is a science-and-practice periodical for medical professionals. The main highlighting issue is pain, but not the only one, because in medicine there are no situations where a phenomenon is strictly isolated. Sign up for a print edition and follow up on the site to keep up with important and useful information.</p> <p>Thematic interests of the journal<br>Fundamental aspects of pain (clinical physiology, pathophysiology, pharmacology).<br>Applied aspects of pain (epidemiology, pain assessment, innovative methods of diagnosis and treatment, clinical pharmacology).<br>Clinical aspects of pain (acute pain, chronic pain, perioperative pain, posthumous pain, neuropathic pain, dysfunctional pain).<br>Clinical and anatomical approach to pain (headache, orofacial pain, neck and back pain, toothache, musculoskeletal pain, myofascial pain, fibromyalgia, visceral pain, pelvic pain, cardialgia, etc.).<br>Interdisciplinary approach to pain (in anesthesiology, in surgery, in pediatrics, neurology, vertebrology, in the clinic of internal diseases, oncology, rheumatology, gerontology, gastroenterology, traumatology and orthopedics, otorhinolaryngology, dentistry, obstetrics, gynecology and urology, in the palliative and hospice medicine).<br>Treatment and rehabilitation of patients suffering from pain (pharmacotherapy, physical rehabilitation, medical rehabilitation, alternative methods of treatment, means of psychological and psychotherapeutic influence, invasive methods of pain relief, organization of pain relief).<br>Separate clinical cases and their clinical examination.</p> Fundamentals of the modern theory of the phenomenon of “pain” in terms of a systematic approach to issues its psychological component. Terminology of the systemic approach and a brief representation of the human body as a system 2018-09-08T17:07:54+03:00 V. I. Poberezhnyi O. V. Marchuk O. S. Shvidyuk I. Y. Petrik <p>“Pain” is psychophysiological phenomenon, that is actualized in the mind of a person as a result of a systemic reaction to a certain external<br>and internal stimuli. The pain is caused by morphological and functional disorders in the body and is accompanied by changes in person’s psychic state<br>and behavior. Three components are distinguished in the phenomenon of “pain”: nocigenic (somatogenic), neurogenic (neuropathic) and psychogenic.<br>The psychical and physiological components are distinguished only within emotions and sensations among all mental processes. The formation<br>of connections and relationships between their components occurs on the basis of neurophysiological processes. Emotions and feelings<br>of a person are inseparably linked with the corresponding physiological processes of the body, which, in turn, are a reflection of a certain<br>form of the systemic structural and functional organization.<br>From the point of view of the functional system approach, the human body is an exposed, nonlinear, self-organizing, self-regulating,<br>self-learning, permanently evolving, dynamic system that exists in inseparable connection and constant interaction with the environment.<br>Elements of its systemic structural and functional organization are certain functional systems of the corresponding hierarchical levels.<br>Regulatory centers are one of the main elements of the human organism’s functional systems, their activities realize the processes of their<br>self-organization and self-regulation. In functional systems at the cellular, tissue, organ and organism levels of its systemic organization,<br>the regulatory centers are the neuronal-synaptic organizations of the structural formations of the peripheral and central nervous system.<br>Nervous system of the person integrates and coordinates the processes of sensitivity, activity of its effector structure formations and<br>motion activity, accordingly to the conditions of its internal and external environment. Realization of its functions as a whole and in<br>full is possible only in inseparable interrelation and mutual relation, coordinated interaction and interconsistency with endocrine and<br>immune-competent systems. The ways and means of intercellular communication are the basis for the processes of integration and coordination<br>of the activity of effector and structural formations of the human body.</p> 2018-08-01T00:00:00+03:00 ##submission.copyrightStatement## Allodynia and hyperalgesia: review 2018-09-08T17:27:05+03:00 K. D. Dmytriiev O. V. Marchuk K. D. Dmytriiev <p>The main purpose was to highlight the problem of hyperalgesia and allodynia. Main anatomic structures, which participate in nociception were mentioned in this article, with pathologic and pathophysiologic changes, that can be caused by hyperalgesia and allodynia. Main methods of diagnostics and assessment of mentioned symptoms were represented along with the modern approaches to treatment and prevention.</p> 2018-09-06T00:00:00+03:00 ##submission.copyrightStatement## A modern view of the problem of treatment of chronic pelvic pain syndrome in boys 2018-09-08T17:07:54+03:00 V. S. Konoplitsky D. V. Dmytriev O. O. Lukianets R. V. Shavlyuk <p>The article deals with the main causes of chronic pelvic pain syndrome (CPPS), some of its pathogenetic mechanisms are depicted. It is noted that at the present time, CPPS, despite its considerable prevalence, remains poorly understood by a disease that is difficult to treat, the adequacy of which is possible only under the strict topical and nosological diagnostics. To date, there are no clearly identifiable etiological factors in the development of CPPS, and existing contradictory data regarding diagnostic criteria significantly reduce the possibility of a clear diagnosis. In addition, there is still no single approach to choosing the best treatment methods for CPPS, and the assessment of a large number of existing treatments for this disease is difficult due to the lack of a standardized system for evaluating the results of treatment. These circumstances, together with the steady course of the disease, lead to the formation of neurotic conditions, which emphasizes not only the purely medical but also the social significance of the problem of increasing the effectiveness of diagnosis and treatment of CPPS in boys at the present stage. The algorithm of diagnostics and treatment of CPPS is proposed, which is based on an individual and comprehensive examination of patients by multidisciplinary interaction with specialists of other specialties related to a specific case that allows choosing pathogenetically grounded treatment tactics</p> 2018-08-01T00:00:00+03:00 ##submission.copyrightStatement## Regional anesthetics: traditions and innovations 2018-09-08T17:07:54+03:00 A. I. Haas D. O. Koval O. O. Haas <p>The wide implementation of different regional anesthesia techniques is also actual in pediatric anesthesiology. Using modern methods of regional anesthesia (RA) and modern local anesthetics is a new level in development of pediatric anesthesiology. This article is about advantages of regional pediatric anesthesia in intra- and post-surgery pain management and analgesia. We analyse the techniques of spinal and epidural anesthesia, as well as their varieties such as unipolar spinal block and caudal anesthesia, compare their advantages and disadvantages. Some more techniques such as paravertebral block, TAP-block are considered as an alternative to epidural anesthesia. Methods and possibilities of ilioinguinal, iliohypogastric and TAP-blocks are also mentioned here. The use of the above-mentioned methods allows to reduce the use of narcotic analgesics and hypnotics and, as a consequence, reduces their systemic effects on the child’s body. These methods are safer for use, since they allow you to plan a safe anesthetic for each child and minimize complications.</p> 2018-09-06T00:00:00+03:00 ##submission.copyrightStatement## Our experience in the application of radiofrequency neuroablation in patients with coxalgia against the background of degenerative osteoarthrosis of the hip joint 2018-09-08T17:07:54+03:00 I. V. Roy Ya. V. Fischenko S. P. Chernobay <p>The article is concerned with the treatment of coxalgia against the background of degenerative-dystrophic diseases of the hip joint. The author carried out an analysis of foreign studies concerning with the application of radiofrequency neural ablation for the hip joint nerves. Based on the results of our own research, the author has proved that radiofrequency neuroablation of articular nervule of obturator and femoral nerves is an effective treatment of coxalgia pain syndrome against the background of degenerative osteoarthrosis</p> 2018-08-01T00:00:00+03:00 ##submission.copyrightStatement## Several aspects of stellate ganglion block 2018-09-08T17:07:54+03:00 E. P. Yevstratov N. V. Krupskaya V. Y. Shumlyanskiy <p><strong>Background and Study Goal.</strong> Stellate ganglion block (SGB) has been used in the treatment of cerebral derangements associated with headache, for the purpose of reliving spasm and presumably increasing the cerebral blood flow, normalizing endovascular resistance.</p> <p><strong>Materials and Methods.</strong> 30 volunteers underwent unilateral SGB, 30–40 years (21 females, 9 males), with cluster headache. 5 ml 0,25 % ropivacaine were administered + 4 mg dexamethasone under C6 level paratracheal ultrasound guid. The confirmation was the presence of Horner´s syndrome. The resistive index (RI) was measured by ultrosound transcranial CV doppler of middle cerebral artery at the baseline and 1 min, and 10 min after SGB on both sides (the other side was taken for control). Normal values of RI corresponded to the age.</p> <p><strong>Results and discussion.</strong> Our observations showed that after SGB in all patients there was a significant change in RI with normalization of cerebral blood flow, reduction or disappearance of headache.</p> <p><strong>Conclusions.</strong> The difference between the block and the nonblock sides was significant before procedure (p &lt; 0,0001) and after 10 min become the same with an insignificant difference (p = 0,001). A higher RI in patients with a cluster headache may be as an indicator for choosing the block side. Ultrasound technique will be helpfull for providing safe block and effect control.</p> 2018-08-01T00:00:00+03:00 ##submission.copyrightStatement## TAP-block as a component of multimodal analgesia for postoperative anesthesia in obstetrics and gynecology 2018-09-08T17:07:54+03:00 Ye. V. Grigimalsky A. Y. Garga <p>Postoperative pain relief is still quite actual problem in medicine, particularly in obstetrics and gynaecology. The most appropriate method of adequate post-operative anesthesia is multimodal analgesia. This article describes the features of multimodal analgesia using TAP-block combined with NSAIDs in obstetric and gynaecological patients, advantages and disadvantages of this combination and our own experience of applying this method in our clinic.</p> 2018-08-01T00:00:00+03:00 ##submission.copyrightStatement## Choosing an anesthetic technique in pregnant women with Arnold – Chiari malformation 2018-09-08T17:07:54+03:00 V. D. Zukin Ye. V. Grigimalsky A. Y. Garga <p>We want to present the clinical case of a female patient with the asymptomatic Chiari I type malformation, without surgical correction and with concomitant epilepsy who underwent planned C-section under epidural anesthesia. A 29-year old pregnant women on the 39 week of pregnancy entered the maternity hospital for the delivery. It was decided to conduct a planned caesarean section. The epidural anesthesia with 0.75 % solution of the ropivacaine was chosen as the method of anesthesia. The patient did not receive antiepileptic treatment due to her implacable refusal. She underwent surgery and anesthesia well. On the third day after surgery, the patient suffered of a convulsive as sault, which was stopped by intravenous administration of diazepam. This article briefly describes the genetic background, classification, clinical manifestations and treatment tactics for patients with Chiari malformation and the features of C-section anesthesia in pregnant women with this pathology.</p> 2018-08-01T00:00:00+03:00 ##submission.copyrightStatement##