Osipova N A, Petrova V V, Lastukhin A V, Kudriavtsev S B, Vashakmadze L A, Khomiakov V M
Anesteziol Reanimatol. 2010 May-Jun(3):29-33.
A procedure has been developed and tested to prevent and treat postoperative pain syndrome during extensive thoracoabdominal surgery for esophageal cancer. The procedure is based on the preventive (12 hours before anesthesia and surgery) application of Durogesic (fentanyl transdermal therapeutic system (TTS)) at an opioid release rate of 50 microg/h for 72 hours. By the end of surgery and anesthesia when intravenous injection of fentanyl is stopped, analgesia continues to be maintdined due to its therapeutic dose coming from TTS. This prevents the development of acute opioid tolerance, hyperalgesia, and destabilization state in the early postanesthetic period and creates the basis for continuous multimodal postoperative analgesia in combination with nonopioid components (lornoxicam, perfalgan) and with none or minimal need for the injectable opioid. This allows an operated patient to have a comfort and stable state. A further investigation on the comparative assessment of the developed procedure with other variants of perioperative systemic and combined anesthesia-analgesia is to be conducted.
已开发并测试了一种程序，用于预防和治疗食管癌广泛胸腹手术后的疼痛综合征。该程序基于在麻醉和手术前12小时预防性应用多瑞吉（芬太尼透皮治疗系统（TTS）），阿片类药物释放速率为50微克/小时，持续72小时。手术和麻醉结束时停止静脉注射芬太尼，由于其治疗剂量来自TTS，镇痛作用仍得以维持。这可防止在麻醉后早期出现急性阿片类药物耐受性、痛觉过敏和不稳定状态，并为与非阿片类成分（氯诺昔康、非普拉宗）联合的持续多模式术后镇痛创造基础，且无需或极少需要注射用阿片类药物。这使手术患者处于舒适和稳定状态。还将对所开发程序与围手术期全身麻醉及联合麻醉 - 镇痛的其他变体进行比较评估的进一步研究。
