Ensuring the effectiveness and safety of peripheral blockades

Adequate analgesia determines the success of the performed surgical intervention. In modern surgery, most of postoperative complications are directly related to ineffective therapy of pain syndrome in the perioperative period. The main principle of modern analgesia is its multicomponence, when analgesia, neurovegetative blockade and relaxation are achieved and potentiated by different drugs and methods. The blockade of nociceptive impulses with a local anesthetic at the transmission stage provides effective, targeted analgesia, hyporefl exia and muscle relaxation, prevents the sensitization of neuroaxial structures, hyperalgesia and the development of postoperative chronic pain syndrome. At the same time, providing analgesia with drugs of central action leads to the ineffectiveness of therapy in 80 % of cases, which has serious consequences.The aim. According to the literature review, to evaluate the effectiveness and safety of peripheral blockades on the example of performing a blockade of the pterygopalatine ganglion.Conclusion. The pterygopalatine blockade has broad indications for use in ophthalmology, which is explained by the complex structure of the pterygopalatine ganglion and the possibility of simultaneous infl uence on sympathetic, parasympathetic and nociceptive innervation. All the presented methods of pterygopalatine blockade performance have their advantages and disadvantages. Ultrasound navigation eliminates technical difficulties and the possibility of damage of the pterygopalatine fossa anatomical structures, ensuring the effectiveness and safety of the pterygopalatine blockade.

Effect of the Croton rhamnifolioides Essential Oil and the Inclusion Complex (OEFC/β-CD) in Antinociceptive Animal Models

This study aims to evaluate the antinociceptive effect of the C. rhamnifolioides leaf essential oil (OEFC) and the β-cyclodextrin inclusion complex (COEFC) and investigate the pain signaling pathways involved in the antinociceptive response. The effects of the OEFC and COEFC on the central nervous system (CNS) were determined by open field and rota-rod assays, and the antinociceptive effect was evaluated via the acetic acid-induced abdominal contortions, formalin, and hot plate models. Swiss (Mus musculus) male mice (20–30 g) were used in both trials. The OEFC (200 mg/kg/v.o-orally) and COEFC (83.5 mg/kg/v.o.) did not present alterations in the CNS. The OEFC (25, 50, 100, and 200 mg/kg/vo.) and COEFC (8.35, 41.75, and 83.5 mg/kg/v.o.) demonstrated antinociceptive effects in the abdominal contortions, formalin, and hot plate tests. The OEFC (25 mg/kg/v.o.) and COEFC (8.35 mg/kg/v.o.) doses showed that the antinociceptive effect involves the activation of the opioid, cholinergic, and vanilloid systems, as well as the L-arginine/NO and α-2 adrenergic receptor pathways. The antinociceptive potential the OEFC and COEFC demonstrate possible alternatives for the therapy of pain. However, the COEFC presented more significant effects at lower doses than the isolated OEFC, where this action may be justified by the properties and advantages of the complexation.

Differentiated approach to the development of methods of pathogenetic therapy of pain dysfunction of the temporomandinary joint

The issues of structural organization, function and diagnosis of diseases of the temporomandibular joint have long attracted the attention of not only morphologists, dentists, maxillofacial surgeons, but also doctors of related specialties. Temporomandibular disorders are among the most common non-odontogenic pain syndromes in the maxillofacial region and are considered a variant of musculoskeletal pain syndrome. Based on the analysis of the results of clinical and functional studies, an algorithm for the management of patients with terminal dentition defects complicated by signs of painful dysfunction of the temporomandibular joint was proposed. Therapeutic measures, depending on the degree of painful dysfunction of the temporomandibular joint, included the following stages: occlusive splint therapy; physiotherapy treatment with dynamic electroneurostimulation; prosthetic treatment of end defects of the dentition; stabilization of the spatial relationship of the jaws. Complex therapeutic measures are aimed at normalizing the functional activity of the dentoalveolar apparatus by restoring the uniform distribution of the occlusal load.

Possibilities of applying of osteopathic correction methods in the treatment of pain syndrome in nephroptosis

Nephroptosis is a condition of pathological mobility of the kidney that exceeds the physiological limits of its displacement from the renal bed. The relevance of nephroptosis is due to the increase in the detection of this pathology with disability in a significant part of patients, as well as the severity of subjective manifestations and the severity of complications. We offer a case from clinical practice that shows the potential of application of osteopathic correction methods in the complex therapy of pain syndrome in nephroptosis.

Combined therapy of pain syndromes: rationale and prospects for potentiation of effects

Pain syndrome accompanies absolute majority of diseases, therefore problems of adequate anesthesia remain acute not only for urgent conditions but also for everyday medical practice. Modern approaches of anesthetic therapy should consider not only pathogenic mechanisms of evolving pain syndrome by a certain patient but also necessity to administer drug combinations. It allows potentiating an analgesic effect, to decrease effective dosages of individual drugs and minimize adverse effects. The administration of non-steroidal anti-inflammatory drugs together with B vitamins and tolperisone is justified in a marked pain syndrome with a spastic component and/or spasms of skeletal muscles, muscle contractures, myofascial pain syndromes, as well in rehabilitation therapy after orthopedic and traumatology surgeries. The article considers pathogenic details of such combined therapy, discloses mechanism of synergic action of the proposed drug combination.

Fehler und Lösungen bei der medikamentösen Therapie chronischer Schmerzen

Chronic pain is a main symptom of many diseases in internal medicine. The symptomatic treatment of pain in medical diseases is the task of the internist. Errors in drug therapy of pain can be reduced by a systematic approach of selection, application and monitoring of used medicine, taking effectiveness, duration, dose, comedication and safety into account.