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Biomedical subjects

A V Syrovegin

Publications and source records attributed to A V Syrovegin.

26 records · Page 2Linked to original sources
PubMedDate not supplied

[Prevention of postoperative pain: pathogenetic bases and clinical aspects].

The trial aimed at development of pathogenetically sound complex of therapeutic measures to prevent postoperative pain or relieve it significantly included 1912 patients after elective surgical interventions on the lower part of the body. It is shown that basic factors in postoperative pain prevention are the following: a) adequate relief of preoperative pain syndrome; b) use of spinal or spinal-epidural anesthesia as the leading anesthesia method; c) preoperative epidural administration of opioid analgetic drugs; d) pre-, intra- and postoperative administrations of drugs affecting N-methyl-D-aspartate-receptors (ketamine, magnesium sulphate) as well as inhibitors of kininogenesis and prostaglandinogenesis. The success lies in a multimodality approach to prevention of postoperative pain syndrome, i.e. maximal eradication of all the factors promoting onset of pain during pre-, intra- and postoperative period with a simultaneous impact on peripheral and central mechanisms of acute pain. Such an approach resulted in a complete prevention of postoperative pain in 46.2% patients while the rest patients had much less intensive pain.

Acute Disease↗
PubMedDate not supplied

[Ropivacaine (naropin), local anesthetic of choice for epidural blockade].

The purpose of this study, carried out in 132 patients with intense acute radicular pain, was search for an optimal local anesthetic to be used in combination with a steroid for therapeutic epidural blockade. Comparative analysis of analgesia attained by epidural injections of 5 ml 2% lidocaine, 4 ml 0.5% bupivacaine, and 4 ml 1% ropivacaine showed the advantages of the latter drug in stable arrest of radicular pain immediately after injection. The duration of analgesia after blockade was 1.4 +/- 0.5, 3.1 +/- 0.3, and 9.5 +/- 1.2 h, respectively. Use of ropivacaine eliminated the main shortcoming of epidural blockade in the treatment of patients with radicular pain, consisting in temporary pain relapse after discontinuation of the local anesthetic effect before development of antiinflammatory effect of the steroid.

Adult↗
PubMedDate not supplied

[Electrophysiological approaches to pain evaluation in clinical practice].

The basic principles of instrumental estimation acute and chronic pain syndrome are presented. Electromyography and restoration of H-reflex permit to estimate the pain and carry out dynamic control during therapeutic procedures for vertebrogenic pain syndrome. The methods mentioned are the components of complex approach to diagnosis of pain syndrome.

Diagnosis, Differential↗
PubMedDate not supplied

[Pain: clinical picture and objective criteria of therapy adequacy].

The paper is dedicated to electroencephalographic monitoring in the therapy and rehabilitation of patients with acute radicular pain syndromes of the disc etiology. Spontaneous electromyograms (EMG) of the shin muscles in healthy and affected legs and stimulation electroneurograms were registered in 52 patients; the readings were subsequently processed on the basis of Fourier analysis for the 4-sec maximal muscle contraction. The studies made it possible to detect the degree of destructive changes in the neuromotor apparatus and to monitor its functional recovery in pharmacotherapy, central and peripheral blocks, artificial correction of movements and in acupuncture.

Adult↗
PubMedDate not supplied

[Evaluation of the effectiveness of transcutaneous electroneuroanalgesia in phantom pain syndrome].

Transcutaneous electroneurostimulation carried out in 24 patients with phantom pain syndrome completely relieved pain in only 25% of patients. A possible cause of poor efficacy of this method is depletion of the endorphin antinociceptive mechanisms. EEG findings indicated a possibility of objectively controlling the course of analgesia. Specific EEG signs of phantom pain syndrome were distinguished: polymorphism of EEG fluctuations, high-frequency rapid or slow electrical activity of the brain, and paroxysmal activity. Normalization of EEG, i.e. appearance of manifest alpha-rhythm, reduction of the intensities of slow-wave and rapid activities with the relevant spectral changes, are signs of a positive effect of the analgesic method used, as exemplified by transcutaneous electroneurostimulation.

Alpha Rhythm↗
PubMedDate not supplied

[The epidural administration of steroids and local anesthetics as the basis for the pathogenetic therapy of a radicular pain syndrome in the stages of its development].

The efficacy of epidural administration of a steroid drug kenalog combined with low-dose 1% lidocaine solution was assessed in 26 patients with discal hernias at various stages of the radicular pain syndrome. Registration of paired H-reflex helped define the neurophysiological criteria objectively indicating cure and normalization of the reduced activities of inhibitory structures of the spinal segmentary system as a result of therapy in patients with the radicular syndrome. The efficacy of this method ranges between 57.3 and 100% and depends on the disease duration, therefore it is preferable at the early stages of the disease (up to 4-6 months). Failure of therapy after 3 successive epidural blockings at 6-7-day intervals may be considered as an indication to surgery.

Adult↗
PubMedDate not supplied

[Current principles of multidisciplinary treatment of pain in orthopedic clinics].

Differentiated strategy of treating patients with acute and chronic pain is developed. Preemptive analgesia is a priority trend in the treatment of acute postoperative pain. The most prevalent method of postoperative analgesia is prolonged opioid epidural analgesia carried out in intensive care wards and other wards by an acute pain management team. For treating patients with chronic painful syndromes, protocols of initial clinical and diagnostic evaluation are developed, permitting the choice of individual treatment strategy. Differentiated complex drug therapy planned with consideration for individual course of the painful syndrome is the basis of treating patients with phantom pain syndrome. Algorithms of differentiated therapy of radicular and spondylogenic pain are designed. Stage-by-stage analysis of treatment efficacy is carried out using modern electrophysiological methods. Realization of the proposed organization principles improved the efficacy of postoperative analgesia to 88.2%, prevented the development of postoperative painful syndrome in 35.6% cases, decreased the incidence of phantom pain syndrome after amputation of the limb from 63.3 to 31.6% and increased the efficacy of this syndrome treatment to 70.1%, and increased the efficacy of treating vertebrogenic painful syndromes to 82.3%.

Algorithms↗