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) Fri, 01 Nov 2019 00:00:00 +0200 OJS 3.1.2.4 http://blogs.law.harvard.edu/tech/rss 60 Mini-invasive methods of treatment of diabetic foot pain https://painmedicine.org.ua/index.php/pnmdcn/article/view/203 <p>Neuropathic pain occurs with diabetic polyneuropathy more often than with all polyneuropathies of another etiology. Because the cause of pain can rarely be cured, treatment is usually symptomatic. Neuropathic pain is usually poorly controlled by analgesics. Management of neuropathic pain is started with conservative pharmacotherapy before invasive pain management is applied. Although there are many drugs that can be used in patients with diabetic pain syndrome, pain syndrome can not be surely stoped with monotherapy. In addition, the patient may not tolerate the full therapeutic dose of the drug.</p> <p>All this dictates the need for combination therapy. It is believed that regional anesthesia as an independent type of analgesia or a component of combined anesthesia is the method of choice for the elderly and senile patients. The main reasons for this choice, when comparing regional anesthesia with narcosis, are less stressful response of the organism, absence of depression of the central nervous system, stable reliable analgesia with complete blockade of nociceptive reflexes with the provision of adequate muscle relaxation, prevention of neurovegetative reactions, which ultimately helps to reduce the incidence of postoperative complications and mortality. Clinicians have accumulated considerable experience demonstrating the need for regional analgesia in the management of diabetic foot pain.</p> Dmytro Dmytriiev, Yevhenii Lysak, Yevhenii Glazov, Stanislav Geranin, Olesia Zaletska Copyright (c) https://painmedicine.org.ua/index.php/pnmdcn/article/view/203 Fri, 01 Nov 2019 00:00:00 +0200 Using the principles of multimodal analgesia as a component of Fast-Track surgery in practice https://painmedicine.org.ua/index.php/pnmdcn/article/view/205 <p><strong>Aim.</strong> To evaluate the effectiveness of reducing postoperative pain in the first days after surgery in accelerating postoperative recovery of patients and reducing the length of stay in hospital.</p> <p><strong>Materials and methods.</strong> In the period from September 2011 to May 2019 we performed 569 scheduled surgeries using the Fast­track surgery principles, including MMA. Depending on the type of surgery, we defined VAS pain impulses indicators and the average stay in hospital.</p> <p><strong>Results.</strong> Analyzing the impulses of pain after laparoscopic cholecystectomy in the first postoperative day (POD) VAS level was 2.87 ± 0.74, the second POD – 2.01 ± 0.50 (p &lt; 0.001). The average hospital stay was 1.72 days. In laparoscopic hernioplasty, the results of the study of the level of pain according to VAS were as follows: the first POD – 3.44 ± 0.67, the second POD – 2.06 ± 0.51 (p &lt; 0.001). The average hospital stay was 1.43 days after surgery. Analyzing laparoscopic bariatric interventions and interventions on the large intestine the first POD level according to VAS was 4.24 ± 0.75 and 4.39 ± 0.84 respectively; the second POD – 3.48 ± 0.57 and 3.48 ± 0.77, the third POD – 2.79 ± 0.67 and 2.84 ± 0.69. When comparing the first and second PODs after bariatric interventions, the level of pain impulsion decreased to 3.48 ± 0.57 (p &lt; 0.001), and to the third POD – to 2.79 ± 0.67 (p &lt; 0.001). A similar tendency was observed after laparoscopic interventions on the large intestine: the second POD – the level of pain impulsion decreased 3.48 ± 0.77 (p &lt; 0.001), the third POD – 2.84 ± 0.69 (p &lt; 0.001). The average hospital stay was 4.99 ± 0.45 and 4.10 ± 0.60, respectively.</p> <p><strong>Conclusions.</strong> The effectiveness of reducing postoperative pain in the first days after surgery directly affects the rate of recovery of the patient and the length of stay in hospital.</p> Oleksandr Ioffe, Oleksandr Stetsenko, Mykola Kryvopustov, Tetiana Tarasiuk, Yurii Tsiura Copyright (c) https://painmedicine.org.ua/index.php/pnmdcn/article/view/205 Fri, 01 Nov 2019 00:00:00 +0200 Efficiency of multimodal anаlgesia in orthopedics and traumatology https://painmedicine.org.ua/index.php/pnmdcn/article/view/206 <p>Проведене клінічне дослідження на 200 пацієнтах, яким в умовах ортопедо­травматологічного стаціонару виконувалось тотальне ендопротезування кульшового та колінного суглобів, а також металоостеосинтез довгих кісток нижніх кінцівок. Усі хворі були розбиті на 2 підгрупи (по 100 пацієнтів у кожній), де в дослідній групі знеболювання проводилось за методикою мультимодальної аналгезії (з використанням вітчизняних препаратів “Інфулган”, інтраопераційно в операційну рану –“Логнокаїн” та “Налбуфін”), в контрольній знеболювання проводилось за традиційною методикою.</p> <p>Оцінка ефективності післяопераційного знеболювання здійснювалася за шкалою болю ВАШ на 2, 7, 14 та 30 добу після оперативного втручання. Проведене дослідження переконливо доводить ефективність призначення мультимодальної аналгезії в післяопераційному періоді хворих ортопедо­травматологічного профілю. Все це дозволило проводити ранню післяопераційну реабілітацію пацієнтів та забезпечило гарний функціональний результат у всіх прооперованих хворих. Мультимодальна аналгезія є сучасною методикою післяопераційного знеболювання при хірургічному лікуванні пацієнтів після перенесених травм і захворювань опорно­рухового апарату і вимагає ширшого застосування в практиці ортопедів­травматологів України.</p> Oleksii Kalashnykov, Yurii Stavynskyi, Kostiantyn Vdovichenko, Andrii Kalashnykov Copyright (c) https://painmedicine.org.ua/index.php/pnmdcn/article/view/206 Fri, 01 Nov 2019 00:00:00 +0200 Anesthesia for caesarean section in pregnant women with kyphoscoliosis: neuraxial or general? https://painmedicine.org.ua/index.php/pnmdcn/article/view/207 <p>Аnesthetic management of cesarean section in pregnant women with severe kyphoscoliosis is quite debatable. It is believed that kyphoscoliosis is a contraindication to neuraxial anesthesia methods. The article presents a successful experience of spinal anesthesia in pregnant women with severe kyphoscoliosis. Authors believe that spinal anesthesia can be successfully performed in pregnant women with severe kyphoscoliosis – paramedian access at the L5–S1 level, due to the anatomical features of these vertebrae.</p> Rostyslav Chaplynskyi, Andrii Horiainov, Anna Omelchenko-Seliukova Copyright (c) https://painmedicine.org.ua/index.php/pnmdcn/article/view/207 Fri, 01 Nov 2019 00:00:00 +0200 Patient-controlled epidural analgesia for labor – a step forward in Ukrainian obstetrics https://painmedicine.org.ua/index.php/pnmdcn/article/view/208 <p>Labour pain is recognized by some women as the most severe pain that they have ever felt in their life. Epidural analgesia is an effective method of pain relief in labour and is considered as the gold standard of analgesia for delivery. Traditionally, epidural analgesia in Ukraine is performed without the ability for the patient to control the process of anesthesia. The authors became interested in the delivery of local anesthetics by patient­controlled epidural analgesia instead of the traditional physician methods. In randomized controlled studies there is an evidence that the PCEA method tends to improve the quality of pain relief and increase the patient satisfaction.</p> Yevhenii Grizhimalsky, Andrii Harha Copyright (c) https://painmedicine.org.ua/index.php/pnmdcn/article/view/208 Fri, 01 Nov 2019 00:00:00 +0200