Оптимизация послеоперационного обезболивания на основе «предупреждающей аналгезии

Аннотация

Subjects of research: 96 children from 1 to 15 years, undergoing on orthopedic, urological, abdominal pathology. 42 patients was done preemptive analgesia by diclofenac, 54 - was done postoperative analgesia on indications. Purpose of work: Optimization of the postoperative analgesia on basis of «Preemptive analgesia» in children and complex estimation of its efficiency. Methods of research: clinical, electrocardiographically, echocardiographically, laboratory, statistical methods. The results obtained and their novelty: First time carried out complex studying of efficiency of anesthesia with non-steroid anti-inflammatory drug -diclofenac in the early postoperative period at children with estimation of vegetotonus, the central hemodynamic, stress - hormone activity (hydrocortisone) in comparison to value judgment on a scale of verbal estimations. Possibility of "preemptive analgesia» with diclofenac introduction in schemes of a premedication to children, with the subsequent estimation of adequacy and quality of a postoperative analgesia was established. There was spent the comparative estimation of various methods of postoperative analgesia with diclofenac in children. Practical value: there were developed various techniques of carrying out of postoperative analgesia with application of diclofenac for children and introduced in clinical practice: on a method of "preemptive analgesia» and «on indications». Advantages and disadvantages of postoperative analgesia «on indications» and by a principle of "preemptive analgesia» with use of diclofenac in children are taped. Indications and contraindications to diclofenac application in the postoperative period in children after various operations arc specified. Degree of embed and economic effectivity: Investigation results arc introduced in practice of Intensive Care Department of Tashkent Pediatric Medical Institute Clinic, Intensive Care Department of Samarkand Scientific Center of Children Surgery. Field of application: anesthesiology, rcanimatology.