Ovechkin A M, Karpov I A, Liuosev S V
Anesteziol Reanimatol. 2003 Sep-Oct(5):45-50.
Analgesia in abdominal surgery is a sufficiently complicated problem. The extensive surgeries in the abdominal cavity are concomitant with massive tissue damages and are associated the systematic tissue inflammatory response to an intensity of the pain syndrome and of other postoperative complications. The modern understanding of surgical-trauma pathophysiology is indicative of the necessity to modulate the systemic inflammatory response whose severity is preconditioned not only by postoperative pain intensity but also by surgical results. With respect to the above stated, multi-model analgesia can be regarded as an optimal technique since it presupposes the long-term administration of local anesthetics (preferably 0.2% ropivakain) concurrently with non-steroid anti-inflammatory drugs used preoperatively (the most effective one is lornoxicam).
腹部手术中的镇痛是一个相当复杂的问题。腹腔内的广泛手术伴随着大量组织损伤,并与疼痛综合征及其他术后并发症的系统性组织炎症反应相关。对手术创伤病理生理学的现代认识表明,有必要调节全身炎症反应,其严重程度不仅取决于术后疼痛强度,还取决于手术结果。鉴于上述情况,多模式镇痛可被视为一种最佳技术,因为它需要长期使用局部麻醉剂(最好是0.2%的罗哌卡因),同时术前使用非甾体类抗炎药(最有效的是氯诺昔康)。