pmjТихоокеанский медицинский журналPacific Medical Journal1609-1175TGMUpmj-904Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHESПрофилактика и лечение боли в периоперационном периоде у больных с вентральными грыжами и сопутствующим ожирениемPain prevention and treatment during the peri-operative period in patients with ventral hernias and associated adiposisНеймаркМ. И.NeimarkM. I.noemail@neicon.ruКиселевР. В.KiselevR. V.fincher-75@mail.ruПлотниковЕ. С.PlotnikovE. S.noemail@neicon.ruАлтайский государственный медицинский университетРоссияAltai State Medical UniversityRussian FederationОтделенческая клиническая больница на ст. Барнаул ОАО РЖДРоссияRegional Clinical Hospital at the Barnaul Station of Russian Railways JSCRussian Federation201228092012033033Copyright © Неймарк М.И., Киселев Р.В., Плотников Е.С., 20122012Неймарк М.И., Киселев Р.В., Плотников Е.С.Neimark M.I., Kiselev R.V., Plotnikov E.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tmj-vgmu.ru/jour/article/view/904

Обследовано 42 больных с индексом массы тела более 40 кг/ м2, которым было выполнено грыжесечение по поводу вентральной грыжи и абдоминопластика. 23 пациента (1-я группа) оперированы в условиях многокомпонентной сбалансированной анестезии на основе низкопоточной ингаляции севофлурана в комбинации с атаралгезией, а в послеоперационном периоде анальгезия достигалась парентеральным введением опиатов в комбинации с нестероидными противовоспалительными препаратами (НПВП). Во 2-й группе (19 пациентов) вмешательства выполнялись в условиях комбинированной анестезии на основе сочетания низкопоточной ингаляции севофлурана и грудной эпидуральной анальгезии, которая обеспечивала послеоперационное обезболивание в сочетании с парентеральным введением НПВП. Показано, что применение комбинированной анестезии в сочетании с послеоперационной эпидуральной анальгезией наропином способствует более быстрому пробуждению и активации больных, более полноценной анальгезии, меньшему количеству послеоперационных осложнений в сравнении с многокомпонентной сбалансированной анестезией в сочетании с системным введением наркотических анальгетиков и НПВП в послеоперационном периоде.

The authors have examined 42 patients with the body-weight index of over 40 kg/m2 undergone herniatomy for the ventral hernia and abdominoplasty. 23 patients (1st group) underwent surgery under the polycomponent balanced anaesthesia on the basis of low-flow inhalation of sevoflurane combined with ataralgesia. During the post-operative period the ataralgesia was achieved by the parenteral infusion of opiates associated with the non-steroid anti-inflammatory drugs (NSAID). The 2nd group (19 patients) underwent combined anaesthesia with the low-flow inhalation of sevoflurane and thoracic epidural anaesthesia that allowed the post-operative anaesthesia combined with the parenteral infusion of the NSAIDs. As reported, the combined anaesthesia with the post-operative epidural analgesia with naropin has facilitated more rapid patients’ awakening and activation and allowed fuller analgesia, lesser number of post-operative complications compared with the polycomponent balanced anaesthesia combined with the system infusion of narcotic analgesics and NSAIDs during the post-operative period.

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The authors declare that there are no conflicts of interest present.