THE USE OF DEXMEDETOMIDINE IN COMBINATION NEFOPAM FOR POSTOPERATIVE ANALGESIA AFTER LAPAROSCOPIC CORRECTION OF MORBID OBESITY.

AIM: To study the possibility of using a combination of dexmedetomidine with nefopam for postoperative analgesia in patients with morbid obesity after bariatric surgery in anesthesia quality aspects and theimpact of the study on the combination during the inflammatory response to surgical trauma. SUBJECTS AND METHODS: A prospective cohort study of 48 patients with obesity. RESULTS: Based on the analysis of hemodynamic parameters, evaluation of pain using a numeric rating scale pain concluded that selective agonist of o-2 adrenergic dexmedetomidine in combination with nefopam provides effective postoperative pain relief in patients who underwent bariatric surgery, and is not a factor for suppression of postoperative inflammatory response Unlike the effects of ketorolac tromethamine, do not always provide a sufficient level of analgesia and reduce the rate of growth in the level of IL-6. CONCLUSION: The combination of dexmedetomidine with nefopam provides sufficient analgesic effect after bariatric surgery, with noted a more rapid onset of analgesia than with ketorolac. Postoperative analgesia and dexmedetomidine nefopam, unlike the use of ketorolac tromethamine, are not violated ratio of interleukins 1 and 6 was not a factor and suppression of postoperative acute phase inflammatory response.

[Impact of preemptive analgesia on postoperative pain syndrome in laparoscopic surgery].

The study included 90 patients who had undergone laparoscopic cholecystectomy. The patients were divided into 3 groups: 1) paracetamol was given for preemptive and postoperative analgesia; 2) ketorolac tromethamine; and 3) promedol (a control group). The visual analogue scale (VAS) and the determination of the time course of changes in the blood levels of tumor necrosis factor-alpha (TNF-alpha), C-reactive protein (CRP), and glucose were used to evaluate the degree of pain syndrome. Preemptive analgesia in laparoscopic surgery using ketorolac and paracetamol could reduce the degree of postoperative pain syndrome by 40.1%, as shown by the VAS. Comparative analysis of the characteristics of the agents showed that paracetamol produced a more powerful antistress defense, as confirmed by the time course of changes in the levels of TNF-alpha and CRP.