Boyko K. Organoprotective analgesia after the urgent and elective laparoscopic surgery in the elderly patients

Results of a comparative estimation of reports traditional postoperative opioid analgesia, preemptive analgesia with use of non-steroid anti-inflammatory drugs (NSAIDs) and clonidine or ketamine and right-side subpleural analgesia at 131 elderly patients after laparoscopic surgery are submitted. On the basis of the received data on infringements of system- and coronary circulation and cardiac rhythm, the fact of organ dysfunction actions of postoperative pain syndrome at elderly patients after laparoscopic surgery is confirmed. It is established, that at elderly patients the self-estimation of a postoperative pain is less, than her vegetative displays as myocardial ischemia and life-threatening arrhythmia. Steady correlations between intensity postoperative pains, incidence of arrhythmias, hearth rate and systolic blood pressure are revealed. Necessity of application the preemptive analgesia with use of NSAIDs and clonidine or ketamine for reduction of postoperative pain syndrome at elderly patients with heart failure on FC I-II NYHA is proved. Application of right-side subpleural blockade as component postoperative analgesia in elderly patients with heart failure on FC III-IV NYHA for reduction of risk of occurrence life-threatening arrhythmias and myocardial ischemia of is proved.