Postoperative pain and modern aspects of analgesia in children
The monograph offered to the attention of readers is devoted to presenting the results of the analysis of modern literature on the problems of postoperative pain relief and summarizing the results of our own clinical experience in the use of various drug methods of analgesia, regional blockades and reflexotherapy methods. The relevance of this monograph is determined by the continuing high frequency of inadequacy of postoperative pain relief (up to 50%, Verlaecki M., 1997). In the specialized literature, both domestic and foreign, the problem of pain in children is still extremely poorly covered. Pain and pain management in children are only briefly mentioned in the leading guidelines for the management of pediatric emergencies. An unresolved problem in pediatric anesthesiology and resuscitation remains an objective assessment of the severity of pain and methods of postoperative pain relief. The monograph provides a brief excursion into the neurophysiology of pain, presents modern theories and concepts on the formation of pain sensations and the characteristics of the reflection of nociceptive stimuli in the CNS. The anatomical and physiological features of the child's organism, the clinical pharmacology of various analgesics are presented, as well as the issues of infusion therapy and parenteral nutrition in the early postoperative period. Getting acquainted with the material of the monograph, the reader will note the fundamental nature of the author's approach to solving the tasks set, and the high level of provision of clinical fragments of the work, in which modern methods of registration, analysis and processing of the information received were used, are the basis for them to formulate detailed conclusions. Comparing various drug methods of analgesia with methods of reflex therapy, regional blockades based on clinical characteristics, influence on the main vital functions of the body, the author gives indications and contraindications for their use depending on the patient's age, trauma and duration of surgery, the severity of postoperative pain syndrome. The author gives clinical cases emphasizing the importance of the problem and focusing on the key points given in the chapters. The monograph, from our point of view, will find a wide range of interested readers.