Pain prevention and treatment during the peri-operative period in patients with ventral hernias and associated adiposis
Abstract
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.
About the Authors
M. I. Neimark
Altai State Medical University
Russian Federation
Russian Federation
R. V. Kiselev
Regional Clinical Hospital at the Barnaul Station of Russian Railways JSC
Russian Federation
Russian Federation
E. S. Plotnikov
Regional Clinical Hospital at the Barnaul Station of Russian Railways JSC
Russian Federation
Russian Federation
References
1. Belokonev V.I., Pushkin S.Ju., Kovaleva Z.V. The abdominal wall plastic in the ventral hernias by combined method, Hirurgija. 2000. No. 8. P. 24-26.
2. Derjugina M.S. The giant hernias long-term treatment results after obstetrical and gynecological operations, Hirurgija. 1997. No. 6. P. 62-63.
3. Nejmark M.I., Kirichuk O.A., Klyzhina E.A. The prevention of cardiovascular complications in aorta and its branches surgery, Obwaja reanimatologija. 2008. No. 2. P. 62-68.
4. Nejmark M.I., Kiselev R.V. The respiratory support optimization in patients with morbid obesity, Plenum pravlenija Federacii anesteziologov i reanimatologov Rossii: tezisy dokladov. Gelendzhik, 2011. P. 113-114.
5. Ovechkin A.M. Prevention of postoperative pain. Pathogenetic basis and clinical application: thesis abstract, M., 2000. 22 p.
6. Rudin Je.P., Bogdanov A.V., Shevchenko V.P. Treatment of postoperative ventral hernias, Vestnik hirurgii. 1990. No. 12. P. 76-78.
7. Timerbulatov V.M., Popov O.S., Popova O.V., Sorokina V.O. Abdominoplasty in ventral hernia operations, Hirurgija. 2006. No. 4. P. 24-27.
8. Fedorov V.D., Adamjan A.A., Gogija B.Sh. The treatment of large and giant postoperative ventral hernias, Hirurgija. 2000. No. 1. P. 11-14.
9. Ferrante M., Vejd Bonkor T. Postoperative Pain: a guide, per. s angl. M.: Medicina, 1998. 715 p.
10. Jashkov Ju.I. The vertical gastroplasty in patients with morbid obesity: thesis abstract, M.,1999. 22 p.
11. Dumanian G.A., Denham W. Comparison of repair techniques for major incisional hernias, Am. J. Surg. 2003. Vol. 185. P. 61-65.
12. Pandazi A., Bourlioti A., Kostopanagiotou A. Bispectral index (BIS) monitoring obese patients undergoing gastric bypass surgery: experience in 23 patients. Obes. Surg. 2005. Vol. 15, No. 1. P. 58.
13. Soderberg M., Thomson D., White T. Respiration, circulation,and anaesthetic management in obesity. Investigation beforeand after jejunoileal bypass, Acta Anaesth. Scand. 1977. Vol. 21. P. 55-61.
14. Szezerba S.R., Dumanian G.A. Definitive surgical treatment of infected or exposed ventral hernia mesh, Ann. Surg. 2003. Vol. 237, No. 3. P. 437-441.
15. Vaughan R., Dauer S., Wise L. Effect of position (semirecumbent versus supine) on postoperative oxygenation in markedly obese subjects, Anesth. Analg. 1976. Vol. 55. P. 37-41.
Review
For citations:
Neimark M.I., Kiselev R.V., Plotnikov E.S. Pain prevention and treatment during the peri-operative period in patients with ventral hernias and associated adiposis. Pacific Medical Journal. 2012;(3):30-33. (In Russ.)
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