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PAIN SYNDROME IN PATIENTS AFTER COMBINED OPERATIONS FOR COMBINED ANORECTAL DISEASES USING MODERN SURGICAL TECHNOLOGIES.

Wiad Lek

November 2022

VINNYTSIA NATIONAL M.I. PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE; PUBLIC NON-PROFIT ENTERPRISE "KHMELNYTSKYI REGIONAL HOSPITAL", UNDER KHMELNYTSKYI REGIONAL COUNCIL, KHMELNYTSKYI, UKRAINE.

Objective: The aim: To compare the pain in patients with combined pathology of the anal canal and rectum after combined operations using modern high-frequency electrosurgical and radio-surgical devices and a conventional metal scalpel.

Patients And Methods: Materials and methods: The results of treatment of 635 patients with combined pathology of the anal canal and rectum using high-frequency electrosurgery and radio-wave surgery, which were divided into 4 study groups, as well as 112 patients using a metal surgical scalpel were analyzed.

Results: Results: Assessing the pain syndrome on the first day of the postoperative period, it was found that it was most pronounced in control group patients, where the need for anal¬gesia 2 % promedol solution was 4±1 ml and in the first, third and fourth study groups patients needed for analgesia 2±1 ml of 2 % promedol solution when using "Surgitron" radio-wave surgery device, "EFA" and "KLS Martin" high-frequency electrosurgical devices respectively.

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The purpose of the case-study was to evaluate the efficiency of non-steroid antiinflammatory drugs (NAD) for postoperative analgesia in children after small-scope surgical interventions. Diclofenac, 1 mg/kg per day administered as rectal suppositories or intramuscular injections after initial narcosis, was used for postoperative analgesia in children of the main group; postoperative analgesia made by analgin and promedol in the control group was compared with the former. Forty-seven children and 10 children with identical diseases like groin hernia, varicocele and dropsy of testicular membranes, were respectively in the main and control groups.

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Different kinds of postoperative analgesia were used in 106 patients after urgent proctological operations. A comparative analysis of the objective and subjective data obtained have shown that epidural anesthesia is the most effective method of postoperative analgesia in urgent proctology.

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The authors have studied the efficacy of narcotic analgesics in the postoperative period by a complex method, including a psychosomatic questionnaire, spirography, volumetry, analgesiometry, as well as a examination of the cardiovascular system and acid-base balance. Under examination were 183 patients subjected to surgery for tumors of the female genitalia and rectum (a lower laparatomy). The analgesic activity of promedol, omnopone, morphine and polyvinly-morpholidone in routine doses was estimated.

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