Pain medicine https://painmedicine.org.ua/index.php/pnmdcn <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> en-US <p><a style="background-color: transparent; color: #007ab2; font-family: &amp;quot; noto sans&amp;quot;,arial,helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: underline; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;" href="http://creativecommons.org/licenses/by/4.0/" rel="license"><img style="border-width: 0px;" src="https://i.creativecommons.org/l/by/4.0/88x31.png" alt="Creative Commons License"></a><br style="background-color: transparent; color: #000000; cursor: text; font-family: &amp;quot; noto sans&amp;quot;,arial,helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; outline-color: #2d8ac7; outline-style: solid; outline-width: 2px; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;"><span style="display: inline !important; float: none; background-color: transparent; color: #000000; cursor: text; font-family: 'Noto Sans',Arial,Helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;">This work is licensed under a </span><a style="background-color: transparent; color: #007ab2; font-family: &amp;quot; noto sans&amp;quot;,arial,helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: underline; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;" href="http://creativecommons.org/licenses/by/4.0/" rel="license">Creative Commons Attribution 4.0 International License</a></p> editor@painmedicine.org.ua (Oleksandr Marchuk) vlvitkovskyi@gmail.com (Viktor Vitkovskyi) Sun, 10 Oct 2021 00:00:00 +0300 OJS 3.3.0.8 http://blogs.law.harvard.edu/tech/rss 60 Multicenter study of the effectiveness of postoperative pain relief in Ukraine using paracetаmol in surgical hospitals – “ROZUM” https://painmedicine.org.ua/index.php/pnmdcn/article/view/266 <p>This article is devoted to the effectiveness of postoperative pain relief in surgical hospitals in Ukraine. Multicenter study of the effectiveness of postoperative pain relief in Ukraine using paracetаmol in surgical hospitals – ROZUM is descibed. The effectiveness of multimodal analgesia and other analgesia in the postoperative period has been determined. Predictors of inadequate pain relief in surgical patients were identified, and the risks of pain syndrome development in a surgical hospital were assessed. The use of paracetamol in the schemes of multim</p> Dmytro Dmitriev, Ya Feleshtynskyi, S Vasyliuk, V Shaprynskyi, Yu Derkach, D Lapshyn Copyright (c) 2021 https://creativecommons.org/licenses/by/4.0 https://painmedicine.org.ua/index.php/pnmdcn/article/view/266 Mon, 15 Nov 2021 00:00:00 +0200 Continuous fentanyl infusion reduces intra-abdominal pressure, postoperative pain and normalizes lungs’ mechanical changes in newborn with viscera-abdominal disproportion in early post-operative period https://painmedicine.org.ua/index.php/pnmdcn/article/view/267 <p>We aimed to study the influence of prolonged administration of fentanyl on postoperative pain, intra­ab­dominal pressure and mechanical lungs’ changes that may happen in neonates in early post­operative period. 30 newborns (in the period from January 2017 to May 2021) with gastroschisis were divided into two groups ac­cordingly to the method of analgesia (14 – morphine hydrochloride; 16 – prolonged infusion of fentanyl). Lungs’ mechanical characteristics, effectiveness of post­operative analgesia, abdominal wall relaxation was studied by monitoring of dynamic compliance (Cdyn), pressure and flow­volume loops, capnography. Apprising analgesia sta­tus, we measured hemodynamic, SаO2, blood level of cortizol, C­reactive protein (CRP), glucose, analyzed post­operative pain syndrome using visual analogue scales (VAS). Intra­abdominal pressure (IAP) was controlled by Cron. For statistic analysis we used Student’s t­test. In the group with morphine, thete was the increase of IAP by 11–12 cm H2O, being stable during some period of time, and also variable levels of pain according to VAS, the in­creasing of CRP from 0.8 ± 0.25 mg/dl by 5 mg/dl, cortisol by 674.4 nmol/l, and blood glucosae rate – 7.4 mmol/l. Periods with high traumatic effects and poor analgesia (morphine group) reasoned the increasing IAP, step by step dynamic compliance decreasing in 3.4 times, resistance increasing in 2.42 times and PIP rising till 22 cm H2O. Di­rect correlation between IAP increase and lungs’ mechanical changes took place. The study has demonstrated that prolonged administration of fentanyl prevented high increase of IAP, CRP, levels of glucose and cortizol and changes of VAS data, lungs’ mechanical characteristics.</p> Konstantin Bercun, Oleksandr Nazarchuk, Oleksandr Dobrovanov, Denis Surkov, Viktor Vidiščák Copyright (c) 2021 https://creativecommons.org/licenses/by/4.0 https://painmedicine.org.ua/index.php/pnmdcn/article/view/267 Mon, 15 Nov 2021 00:00:00 +0200 A comparative study of caudal anesthesia with bupivacaine v/s bupivacaine with dexmedetomidine in lower abdominal surgeries in pediatric age group https://painmedicine.org.ua/index.php/pnmdcn/article/view/268 <p><strong>Background:</strong> caudal anaesthesia has short­term effect. Alpha­2 adenoreceptors when used as adjuvant to local anaesthetic in children prolongs analgesic duration. The study is aimed to assess the efficacy of addition of dexme­detomidine with Bupivacaine in caudal block for extending postoperative analgesia and its safety profile in pediatric infra­umbilical surgeries.<br><strong>Method:</strong> the prospective interventional longitudinal double blinded study was conducted on 60 patients randomly divided into two groups by simple lottery method: group B who received (0.25 %) bupivacaine 1 ml/kg plus 1 ml nor­mal saline (NS), and those in group BD who received (0.25 %) bupivacaine 1 ml/kg plus 0.5 μg/kg dexmedetomidine in 1 ml NS. Post­surgery, both groups were compared in R studio v1.2.5001. Association between the adverse effect and other variables (age, gender, type of surgery, groups) were assessed by Multiple linear regression.<br><strong>Results:</strong> in group BD, duration of analgesia prolonged significantly (P &lt; 0.05). In group BD, FLACC score at initial four hours and at 12th hour was significantly less (P &lt; 0.05). Group B was more likely to receive high number of rescue analgesia (P = 0.0005; OR = 11.769). No significant difference was observed concerning hemodynamics, respiratory parameters and adverse effect between both groups (P &gt; 0.05). <br><strong>Conclusion:</strong> in children, dexmedetomidine when used along with bupivacaine prolongs postoperative analgesia du­ration, without any significant side effects.</p> Kishore Kumar N., Sandeep Kadam Copyright (c) 2021 https://creativecommons.org/licenses/by/4.0 https://painmedicine.org.ua/index.php/pnmdcn/article/view/268 Mon, 15 Nov 2021 00:00:00 +0200 Pain and discomfort in violation of bowel movements in children – an actual problem https://painmedicine.org.ua/index.php/pnmdcn/article/view/269 <p>Pain and discomfort during bowel movements in children are among the most common symptoms in the modern civilized world. The most common cause of these symptoms is chronic constipation, which is often treated by a pediatrician or pediatric gastroenterologist. In differen­tial diagnosis, it is very important to distinguish between chronic symptomatic constipation and functional (without an organic basis), which are most common in childhood. Organic causes of constipation are usually dealt with in cooperation with specialized specialists. The main patho­physiological mechanisms of functional constipation are stress, pain during emptying, and fear of further painful bowel movements. The clinical picture is dominated by in­frequent and difficult defecation of a large amount of hard stools. If the history, laboratory and other additional stud­ies indicate functional constipation, and there are no warn­ing signs of chronic symptomatic constipation, complex treatment can be started. Therapy includes psychological preparation of the patient and his family, working with the correct technique of defecation, dietary and regimen mea­sures, sufficient physical activity, the use of osmotic lax­atives. The presence of warning signs requires a rational differential diagnostic procedure, which varies depending on the age of the child.</p> K Dmitrieva, V Vidiscak, A Prochotsky, K Furkova, E Kovacsova, P Stefanik Copyright (c) 2021 https://creativecommons.org/licenses/by/4.0 https://painmedicine.org.ua/index.php/pnmdcn/article/view/269 Mon, 15 Nov 2021 00:00:00 +0200 Experience of Dexmedetomidine using for intraoperative analgosedation during ophthalmic operations https://painmedicine.org.ua/index.php/pnmdcn/article/view/270 <p><strong>Background.</strong> The aim of the study is to evaluate the quality and safety of the sedative effect of anesthesia in ambulant ophthalmic surgery by using continuous intravenous infu­sion of Dexmedetomidine. <br><strong>Materials and Methods.</strong> Patients were randomized into groups by age (people from 65 to 75 years old, old age 76 years, middle age, young people, children), by gender (men, women). The physical status of patients was assessed using the ASA scale and the dynamics of vegetatic activity by the Kerdo index. Sedation was assessed using the Richmond Sedation Scale RASS.<br><strong>Results.</strong> It was found that the difference in the frequency of adverse effects of the appointment of Dexmedetomidine clearly confirms the need to adjust the dose of Dexmede­tomidine, depending on the state of the autonomic nervous system. The use of Dexmedetomidine according to the rec­ommendations made it possible to achieve a safe level of sedation and eliminate side effects in ambulant ophthalmic surgery.<br><strong>Conclusions:</strong></p> <ol> <li class="show">Parenteral continuous infusion of Dexmedetomidine pro­vides an effective level of sedation for ambulant ophthalmic surgery and maintaining patient­surgeon contact.</li> <li class="show">Safety is confirmed by a low level of critical incidents, no respiratory depression at the target sedation level.</li> <li class="show">The patency of the upper airways was better compared to previous experience with propofol.</li> </ol> Maxim Khodakovsky Copyright (c) 2021 https://creativecommons.org/licenses/by/4.0 https://painmedicine.org.ua/index.php/pnmdcn/article/view/270 Mon, 15 Nov 2021 00:00:00 +0200