The effects of postoperative pain management on immune response to surgery.

Surgery is associated with immune alterations, which are the combined result of tissue damage, anesthesia, postoperative pain, and psychological stress. In the present study, we compared the effects of several postoperative pain management techniques on postoperative immune function. Patients hospitalized for abdominal surgery were randomly assigned to one of three postoperative pain management techniques: opiates on demand (intermittent opiate regimen [IOR]), patient-controlled analgesia (PCA), and patient-controlled epidural analgesia (PCEA).

[Lymphocyte peptide index in evaluation of the severity of the conditions of patients in critical states].

The article presents results of determination of the peptide index in patients in critical state. The diagnostic value of the lymphocyte peptide index for an adequate estimation of severity of the patients' state and possible prognosis of their disease was determined.

[Liver circulation during acute cardiac insufficiency and the use of intra-aortic balloon counterpulsation].

Liver hemodynamics was experimentally studied in a model of acute heart failure caused by successive ligation of coronary artery branches and the following cardiogenic shock and during assisted circulation using intraaortic balloon contrapulsation. It has been established that intraaortic balloon contrapulsation promotes to the elimination of hemodynamic liver disturbances, however no final recovery of the organ hemodynamics was observed after 2 hours of contrapulsation. The method of intraaortic balloon contrapulsation is recommended at early stages of acute heart failure prior to the onset of profound ischemic changes in the liver.

[The effect of intra-aortic balloon counterpulsation on the metabolism of the heart in acute cardiac insufficiency].

Myocardial metabolism has been experimentally studied in acute heart failure caused by the ligation of the left coronary artery branches and during intraaortic balloon counterpulsation. It has been shown that experimental acute heart failure and developing cardiogenic shock are accompanied by progressive deterioration in myocardial energy supply with predominant anaerobic metabolism. In intraaortic balloon counterpulsation and sufficient O2 supply of the myocardium nonesterified fatty acids are primarily metabolized.