[The effect of various multimodal analgesia regimens during surgical treatment of patients with spinal stenosis on the rate of failed back surgery syndrome]. / Vliianie razlichnykh mul'timodal'nykh skhem analgezii pri khirurgicheskom lechenii patsientov so stenozom pozvonochnogo kanala na chastotu sindroma neudachnoi operatsii na pozvonochnike.

OBJECTIVE: To determine the effect of various methods of perioperative analgesia on the rate of failed back surgery syndrome in patients operated on for spinal stenosis. MATERIAL AND METHODS: A total of 122 patients were operated on for spinal stenosis in 2010-2016. The patients were assigned to groups according to the type of received analgesia: Group K (n=19) underwent analgesia on-demand. Patients in the PMA group (n=21) received preventive multimodal analgesia (PMA) with ketoprofen, paracetamol and morphine. Patients in the PMA+PG (n=20) and PMA+N (n=20) groups additionally received pregabalin and nefopam, respectively. Patients in the PMA+E group (n=22) received continuous epidural analgesia with a combination of ropivacaine and morphine. In patients in the PMA+I group (n=20), the wound was infiltrated with ropivacaine and ketorolac. RESULTS AND CONCLUSION: In Group K, analgesia was not adequate during five postoperative days. Analgesia with PMA resulted in significant pain reduction during three postoperative days compared to Group K. Wound infiltration in addition to PMA was followed by more significant pain relief during six postoperative hours (compared to the PMA group). Administration of pregabalin or nefopam, as well as epidural analgesia, did not improve quality of postoperative analgesia. Five to seven months after the surgery, 66% (57; 75%) of patients had low back and/or leg pain; 41% (32; 50%) of patients had leg pain. Among patients suffering from pain, 32-41% patients had the severe chronic pain syndrome that resulted in sleep disorder, disability and significant deterioration of quality of life. The rate of failed back surgery syndrome did not depend on the perioperative analgesia regimen.

[Prognostic models of the severity of acute dynamic pain on the first postoperative day and the likelihood of chronic postoperative pain in spine surgery]. / Prognosticheskie modeli vyrazhennosti ostroi dinamicheskoi boli v pervye sutki posle operatsii i veroiatnosti vozniknoveniia khronicheskoi posleoperatsionnoi boli v khirurgii pozvonochnika.

The risk factors for acute pain as well as chronic pain syndrome (CPS) in spine surgery have not been defined to date. PURPOSE: To define the prognostic parameters of acute pain severity and the risk of CPS in patients operated on for spinal diseases and injuries. MATERIAL AND METHODS: The study included 291 patients operated on for degenerative diseases and injuries of the spine at the Sklifosovsky Research Institute of Emergency Medicine in 2010-2016. Sociodemographic and clinical data and the psychological status of patients were evaluated. A mechanical algometer was used to measure the pain threshold (PT) and pain tolerance. The movement pain intensity was assessed by using a visual analog scale (VAS) on the day of surgery. Pain was considered minor at a median score of 0-4 cm and severe at a median score of 5-10 cm. The presence of CPS was assessed during a telephone survey 5-7 months after surgery. RESULTS: The gender, PT, dynamic pain intensity before surgery, and expectation of postoperative pain are risk factors for severe acute postoperative pain. A multinomial logit regression model (Hosmer-Lemeshow test - 4.322; p=0.827) predicts minor dynamic pain on the 1st postoperative day with an accuracy of 70% (95% CI 63-76). The age and dynamic pain intensity on the 1st postoperative are the risk factors for CPS; the multinomial logit regression model (Hosmer-Lemeshow test - 3.1; p=0.928) predicts CPS with an accuracy of 65% (95% CI 59-71) 5-7 months after surgery. CONCLUSION: The developed software in the form of MS Excel calculators provides a particular patient with preoperative assessment of the risk for minor acute dynamic pain on the 1st postoperative day and CPS 5-7 months after surgery.

[Expression of genes coding NGF and BDNF human proteins in embryos of transgenic stocks of Drosophila melanogaster]. / Ekspressia genov kodiruiushchikh belki NGF i BDNF cheloveka, v émbrionakh transgennykh linii Drosophila melanogaster.

Transgenic Drosophila stocks were selected. These stocks contained human ngf and bdnf genes under Drosophila heat-shock promoter. The expression of foreign genes during Drosophila development was demonstrated with Northern and whole mount hybridization.