Dolzhenko M. Features of pain syndrome in cases of polytrauma in geriatric patients.

. It has been investigated the development and course of the pain syndrome and the effect of different schemes of postoperative analgesia in 94 gerontological patients with skeletal polytrauma. It has been proved on the basis of study of stress-markers (the glucose and cortisol levels in the blood serum) and subjective method of estimation of pain intensity (visual analog scale of pain), that the use of morphine hydrochloride and nalbuphine hydrochloride and combinations of central and peripheral cyclooxygenase (COG) inhibitors, such as paracetamol and meloxicam, has identical analgesic efficiency after surgery. It has been studied side effects of different schemes of postoperative analgesia: respiratory depression (by pCO2 and breath rate), nausea, somnolence, skin itching. It has been shown, that using of morphine for postoperative analgesia is the most unsafe. It has been determined the concentration of mediators of systemic inflammatory response (SIR) - interleukins 6 and 8, the concentration of endothelin 1, parameters of regulation of aggregate state of blood (RASB) system - soluble fibrin-monomeric complex (SFMC) and antithrombin III (AT III). It has been proven that postoperative analgesia by COG-inhibitors combination is the most pathogenetically reasonable because it aborts pain syndrome by decreasing SIR-mediators concentration which are etiological factors of pain, influences positively on RASB-system, and does not cause side effects which are typical for opiates.