[Regional and peripheral blockades for prevention of chronic post-thoracotomy pain syndrome in oncosurgical practice]. / Primenenie regionarnykh i perifericheskikh blokad dlia profilaktiki khronicheskogo posttorakotomicheskogo bolevogo sindroma v onkokhirurgicheskoi praktike.

AIM: To compare an effectiveness of thoracic epidural anesthesia/analgesia, paravertebral and intercostal blockades in prevention of chronic post-thoracotomy pain syndrome (CPTPS) in oncosurgery. MATERIAL AND METHODS: There were 300 patients who underwent open surgery including lobectomy or pneumonectomy. Patients were randomized into 3 groups depending on type of anesthesia: TEA (n=100) - combined general and epidural anesthesia; PVB (n=50) - combined general and paravertebral anesthesia; ICB (n=50) - general anesthesia was supplemented by intercostal blockade after removal of the drug. RESULTS: CPTPS incidence was 34 and 40% in 6 months postoperatively after PVB and ICB, respectively (p>0.05). In TEA group this value was significantly lower compared with ICB group (23%, p<0.05). CONCLUSION: TEA contributes to significant reduction of CPTPS incidence, while paravertebral blockade does not affect the frequency of this complication.

[Role of migraine history in the development of postoperative nausea and vomiting in patients undergoing general and combined general-epidural anesthesia].

PURPOSE OF THE STUDY: To assess the role of migraine history in the development of postoperative nausea and vomiting (PONV) in patients undergoing general and combined general-epidural anaesthesia. MATERIALS AND METHODS: 127 women with oncogynecological pathology were randomized into 3 groups according to anaesthesia method. Patients of the group C (comparative group; n = 43; 18 with migraine) received general anaesthesia. Patients of the Group CA (n = 40; 19 with migraine) received combined general-epidural anaesthesia. Patients of the group D (n = 44; 19 with migraine) received general anaesthesia with adding of Droperidolum. All patients received standard prophylactics of PONV- Ondansetronum 8 mg and dexamethasone 8 mg intravenous. RESULTS: In the group C a PONV occurred in 15 of 43 women (34.9%). PONV occurred in 6 of 18 women with migraine (33.3%) and in 9 of 25 women without migraine (36%). In the group CA a PONV occurred in 10 of 40 women (25%). PONV occurred in 8 of 19 women with migraine (42.1%) and in 2 of 21 women without migraine (9.5%; p = 0.036 in comparison with group C). In the group D a PONV occurred in 8 of 44 women (18.2%). PONV occurred in 1 of 19 women with migraine (5.3% p = 0.03 in comparison with group C and p = 0.008 with group CA) and in 7 of 25 women without migraine (28%; there was no significant difference with groups C and CA). CONCLUSIONS: Migraine history is a significant risk factor of PONV. Epidural component of anaesthesia does not effect on frequency of PONV in women with migraine, but Droperidolum use allows increasing the frequency of PONV.

[Prophylaxis of hepatic insufficiency after major hepatic resections].

UNLABELLED: The article deals with a problem of prophylaxis of hepatic insufficiency in oncological patients after liver resections. MATERIALS AND METHODS: We analyzed data of effectiveness and safety of the use of Remaxol in oncological patients with hepatic metastasis of colorectal cancer--dynamics of indicators of cytolysis and cholestasis, hepatic protein synthesis, exchange of pigments, pro- and antioxidant system and the level of endogen intoxication in postoperative period. RESULTS: Use of Remaxol allows decreasing the duration of postoperative rehabilitation and intensive care unit staying.