[Treatment of acute postoperative pain and prevention of chronic postoperative pain syndrome].

Objective: To analyze the effectiveness of cognitive-behavioral therapy (CBT) combined with pharmacotherapy for treatment and prevention postoperative pain syndrome.

Material And Methods: The study included 62 patients after cardiac surgery. In the main group (=31), patients underwent standard therapy combined with CBT including cognitive restructuring, behavioral activation and exposure therapy.

[Transitional pain service in surgery as an optimal strategy for the treatment and prevention of chronic postoperative pain].

The problem of chronic postoperative pain (CPP) has remained relevant over the past decades, despite the active development of anesthesiology and surgery. Existing approaches to the treatment of acute postoperative pain do not provide effective prevention of CPP. The analysis of the results of studies on this problem was carried out.

[Functional assessment of internal carotid artery tortuosity in patients with multifocal atherosclerosis].

The review is devoted to diagnosis and treatment of internal carotid artery tortuosity. The authors consider modern classification, epidemiology and diagnostic options using neuroimaging or ultrasound-assisted functional stress tests depending on medical history and complaints. In addition to standard Doppler ultrasound, rotational and orthostatic tests are advisable due to possible changes of local shape and hemodynamic parameters following body position changes, especially in patients with concomitant atherosclerotic stenosis.

[Dynamic functional assessment of internal carotid artery tortuosity in patients with multifocal atherosclerosis].

A personalized approach with attention to anamnesis and specific symptoms is necessary in patients with internal carotid artery tortuosity. Neuroimaging (especially before elective surgery) or functional stress tests following ultrasound of supra-aortic vessels may be necessary depending on medical history and complaints. In addition to standard Doppler ultrasound, these patients should undergo rotational and orthostatic transformation tests.

[Reflexology in patient rehabilitation with postoperative pain. (Literature review)].

Postoperative pain is a pressing medical problem, as it significantly reduces the quality of life of patients after surgical treatment. Chronic postoperative pain further disables patients and impairs their functional activity. Being a widespread interdisciplinary problem, postoperative pain requires the integration of various pain management methods in complex multimodal pain management in the acute period and treatment programs for its chronicity.

[Treatment and prevention phantom pain syndrome in mine-explosive injuries].

Phantom pain syndrome significantly impairs the quality of life and effectiveness of surgical treatment after limb amputations. The authors consider possible strategies for treatment and prevention in elective surgical intervention and mine-explosive injuries.

[Chronic postoperative pain].

The problem of chronic postoperative pain has been actualized for the last 20 years all over the world. At least 10-40% of patients suffer from chronic pain after surgery. This review is devoted to the current state of the problem of chronic postoperative pain, risk factors and prediction of chronic pain.

[Evaluation of immediate complications and 10-years neurological outcomes in patients after reconstructive interventions on the ascending aorta and the aortic arch].

Objective: To estimate the frequency of early postoperative neurological complications in patients undergoing planned surgery on the ascending aortic and arch of the aorta, and their long-term outcomes.

Material And Methods: The prospective study included 100 patients who were operated on at the FSBSI Petrovsky Russian Research Center of Surgery. In group I (=50), operations were performed on the aortic arch with hypothermic circulatory arrest (26 °C) and antegrade cerebral perfusion.

[The efficacy of therapeutic nerve blocks in patients with cervicogenic headache].

Aim: To compare the efficacy of 2% articaine solution and 2% lidocaine solution used to perform therapeutic nerve blocks of the large occipital nerve in patients with cervicogenic headache.

Material And Methods: A randomized prospective comparative clinical study was conducted in two groups treated with articaine (n=22) or lidocaine (n=21). The therapeutic great occipital nerve blocks were performed on the 1st, 3d and 5th days of treatment.

[Differential diagnosis of neurological conditions in cardiac patients on the first day after cardiac, ascending aortic and aortic arch surgery and repair of internal carotid arteries].

The review is devoted to analysis of current trends in interdisciplinary approach to the differential diagnosis of patients' conditions on the first day after cardiac, ascending aortic and aortic arch surgery and repair of internal carotid arteries (neurological disorders, delirium, cognitive dysfunction, psycho-emotional disorders, postoperative sedation). This approach is valuable to determine the prognosis and timely treatment. The basic concepts reflecting the discussion between neurologists, cardiovascular surgeons, anesthetists, radiation diagnostics specialists and rehabilitators are summarized.

An analysis of blood flow indicators in pathological kinked internal carotid arteries with their orthostatic and rotational positions.

Aim: To assess the dynamics of blood flow in patients with hemodynamically significant pathological kinked internal carotid arteries (PK ICA) with their orthostatic and rotational positions.

Material And Methods: Eighty-six patients, including 35 with PK ICA due to fibromuscular dysplasia (FMD) and 51 with PK ICA due to hypertensive heart disease, and 20 healthy people were examined. All patients underwent Doppler ultrasound scanning.

[Early and long-term cognitive disorders after carotid endarterectomy].

Aim: To identify correlation of carotid endarterectomy with neurocognitive function and psycho-emotional state changes.

Material And Methods: There were 120 patients with internal carotid arteries (ICA) stenoses for the period from September 2013 to December 2016. The main group consisted of 100 patients undergoing carotid endarterectomy for internal carotid artery stenosis, control group - 20 patients who refused surgery in 2014-2016.

[A neuropathic component of lumboischialgia: mechanisms of development and treatment approaches].

Low back pain (LBP) is accompanied by the development of pain syndrome that spreads into the leg in 25-57% of patients. This is an important factor predicting the risk of transition of pain from acute to chronic and is an indirect indicator of disease severity. It is often impossible to specify the primary mechanism facilitated pain irradiation in lumboischialgia because many structures can cause analogous symptoms.

[Treatment of myofascial pain syndrome].

Objective: To study different methods of treatment of patients with myofascial pain syndrome (MFPS).

Material And Methods: We evaluated the efficacy of complex treatment in 152 patients with chronic tension-type headache (СЕЕР) and 96 patients with facial MFPS. The treatment included standard methods (reflex therapy of СЕЕР and local injections of a combination of local anesthetics with small doses of steroids in trigger points in patients with facial MFPS.

[The results of early neurocognitive and neuropsychological testing in patients after ascending aorta and aortic arch surgeries].

It was investigated 30 patients after reconstructive ascending aorta and aortic arch surgeries. Neurocognitive testing was performed 2-3 days before surgery, through 24 hours and 10 days after surgery. Neurocognitive tests included Psychiatric Rating Scale, test "Information-Memory-Consideration Concentration", frontal dysfunction battery and test of clock drawing.

[Possibilities for the instrumental monitoring of neuralgia therapy].

Aim: To study the possibility of using a paired (test) H-reflex recovery test in the expert assessment of the intensity of acute pain syndromes and in the control of performed therapy.

Subjects And Methods: The authors analyzed 40 patients treated for radicular pain syndrome (RPS) caused by disk protrusion or herniation at the lumbar spine with the pain intensity of up to 9 points on digital rank scale of pain. As a clinical model they used a pathogenetically sound therapeutic blockade method including glucocorticosteroids for the therapy of acute neuralgia and basic medical therapy with Arcoxia 120 mg/day.

[Local invasive treatment of chronic pain].

The literature on methods of invasive local treatment of chronic pain was analyzed. We reviewed 14 publications including meta-analyses and systematic reviews. The use of regional anesthesia conducted by anesthesiologists in pain clinics demonstrated the evidence based efficacy of different types of peridural injections of local anesthetics with steroids in patients with root pain syndromes at cervical and lumbar levels.

[Odontogenic pain syndrome: integrated approach in analgesia].

The article deals with the study of 96 patients (69 women and 27 men) with odontogenic facial pain syndrome. All patients received complex neurodentist examination with radiological assessment of maxillofacial area and additional functional methods. Patients were divided into two groups, 48 patients in each group.

[Treatment and rehabilitation of patients with pain syndrome in surgical clinic].

Though the progress of modern medicine in understanding the mechanisms of pain and its treatment is significant, the problem of organizing help to the patients with pain syndrome is still actual and undecided. The issue highlights the general types of pain among surgical patients, as well as the integrative approach to the treatment and rehabilitation.

[The neurocognitive and neuropsychological testing in cardiac surgery].

Studying the cognitive disorders after cardiac surgery is on of the pressing question nowadays. Cognitive and psychoemotional disorders are associated with presence of general pathogenetic factors (phenomenon of isolation and frontal dysfunction) and directly influence each other. Only combined neurocognitive and neuropsychological testing makes it possible to define the presence and degree of disorder's intensity.

[The necessity and possibilities of the antipain help organization in multyprofile clinics].

The personal work experience of the department of pain syndrome and analysis of foreign algologic service clearly demonstrated the necessity of similar adequate hierarchical medical service for treatment of chronic pain. The following principles should build the backbone of the service: multidisciplinary approach, usage of both traditional and alternative medicine, availability of help and stable feedback with tertiary hospitals. The algologic service should perform diagnostic, advisory and expert functions.

[The methodology on the study of blink reflex and its normative parameters].

The study of blink reflex is a modern and high informative method of electroneurophysiological diagnosis. The data of clinical studies are controversial that confirm the actuality of the problem and indicate the necessity of universal approaches to methodology and interpretation of obtained results. We studied peculiarities of reflex electromyographic (EMG) components of blink reflex of the circular eye muscle during the electric stimulation of the supraorbital nerve in 31 healthy people.