Horoshko V. Treatment of pain in patients with gunshot and mine-explosive wounds in the stages of treatment

Українська версія

Thesis for the degree of Doctor of Science (DSc)

State registration number

0524U000161

Thesis Registration Form

0524U000161.pdf

Applicant for

Specialization

  • 14.01.30 - Анестезіологія та інтенсивна терапія

11-06-2024

Specialized Academic Board

Д 26.003.11

Bogomolets National Medical University

Essay

Mine-blast wounds account for approximately 25-30% of combat sanitary casualties in the Anti-Terrorist Operation/Joint Forces Operation, while gunshot wounds account for 70- 75%. Mine-blast wounds are characterized by significant body damage and in 83.3% of cases, patients with such injuries suffer from chronic pain. Unfortunately, the situation is the same for patients with gunshot wounds after treatment - the pain becomes chronic in 70% of cases. Given this high frequency of chronic pain in this category of patients, the war in Ukraine, and the large number of patients with this pathology, this issue may be of national importance. Chronic pain in patients who participated in combat operations and performed tasks defending their country is a constant reminder of the injury, the conditions of combat operations during which the patient was injured, and has a significant impact on the results of treatment of post- traumatic stress disorders. There is little data on the treatment of pain in patients with gunshot and mine-blast wounds at the stages of treatment, and these data are mostly presented in reviews or individual clinical cases. That is why an in-depth study of this problem and the solution of such a complex clinical problem is necessary, as Ukraine's defenders should receive the best possible care. Relationship of the work to scientific programs, plans, topics. The dissertation is a fragment of the research topic of the Department of Surgery, Anesthesiology and Intensive Care of the Institute of Postgraduate Education of the Bogomolets National Medical University "Development and improvement of new technologies in diagnostics and surgical interventions in patients with combined surgical pathology" (No 0117U00263 state registration of the research work). The aim of the study is to improve the results of pain treatment in patients with gunshot and mine-blast wounds at the stages of treatment by optimizing the therapeutic tactics of pain relief and developing a concept of pain treatment to reduce the frequency of its chronicity. Research objectives: 1. To study the peculiarities of pain in patients with gunshot wounds depending on the localization of the wound at different stages of treatment. 2. To study the features of pain in patients with mine-blast wounds depending on the localization of the wound at different stages of treatment. 3. To identify predictors of negative results of pain treatment in patients with gunshot wounds. 4. To identify predictors of negative results of pain treatment in patients with mine- blast wounds. 5. To study the influence of the patient's psychological status on the results of pain treatment in patients with gunshot and mine-blast wounds. 6. To investigate the effect of the extent of damage and surgical interventions on the results of pain treatment in patients with gunshot and mine-blast wounds. 7. To investigate the effectiveness of therapeutic tactics of pain relief in patients with gunshot and mine-blast wounds. 8. To study the influence of surgical treatment results on the formation of chronic pain. 9. To identify predictors of chronic pain in patients with gunshot and mine-blast wounds. 10. To investigate the effect of therapeutic tactics of pain relief on the long-term results of pain treatment in patients with gunshot and mine-blast wounds. 11. To substantiate the concept of pain treatment in patients with gunshot and mine- blast wounds and to develop an algorithm for pain management at all stages of their treatment.

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Research papers

Горошко В.Р. Лікування болю у пацієнтів з мінно-вибуховими пораненнями на етапі лікування у військово-медичних клінічних центрах / Кучин Ю.Л., Горошко В.Р.// Буковинський медичний вісник. – 2022. – Т. 26. – №4 (104). – С. 29-36. DOI: 10.24061/2413- 0737.XXVІ.4.104.2022.5

2. Горошко В.Р. Вплив кількості поранених анатомічних ділянок тіла у пацієнтів з мінно-вибуховими пораненнями на результати лікування болю на етапах лікування / Кучин Ю.Л., Горошко В.Р.// Біль, знеболення та інтенсивна терапія. – 2022. – №4 (101). – С. 18-24. DOI: 10.25284/2519-2078.4(101).2022.275113

3. Horoshko V. Experience with human normal immunoglobulin in patients with gunshot wounds and sepsis / Horoshko V., Buhayi O.// Emergency Medicine (Ukraine). – 2022. – 18(6). – 29-32. https://doi.org/10.22141/2224-0586.18.6.2022.1517

4. Horoshko V. Chronic pain in patients with gunshot wounds / Kuchyn I., Horoshko V.// BMC Anesthesiol. – 2023. – 47. https://doi.org/10.1186/s12871-023-02005-3

5. Горошко В.Р. Вплив обсягу пошкоджень і оперативних втручань на результати лікування болю у пацієнтів з вогнепальними та мінно-вибуховими пораненнями / Кучин Ю.Л., Горошко В.Р.// Сучасні аспекти військової медицини. – 2023. – Т.30. – №1. С. 65-72. DOI: 10.3275/2310-4910-2023-30-1-05

6. Horoshko V. Education of an anesthesiologist in the conditions of the russian- Ukrainian war and the results of pain treatment in patients with gunshot and mine-explosive wounds during the stages of treatment in the Armed Forces of Ukraine / Kuchyn Iu., Horoshko V.// EUROPEAN HUMANITIES STUDIES: State and Society. 2022. – 4. – 140-155. https://doi.org/10.38014/ehs-ss.2022.4.10

7. Горошко В.Р. Ефективність лікувальних тактик знеболення пацієнтів з вогнепальними та мінно-вибуховими пораненнями на етапах лікування / Кучин Ю.Л., Горошко В.Р.// Медична наука України. – 2023. – Т.19. – №1. С. 3-11. DOI: https://doi.org/10.32345/2664-4738.1.2023.01

8. Horoshko V. Features of pain in patients with gunshot wounds depending on the location of injury at the stages of treatment / Kuchyn Iu., Horoshko V.// Emergency Medicine (Ukraine). – 2023. – 19(2). – 76-82. DOI: 10.22141/2224-0586.19.2.2023.1561

9. Horoshko V. The relationship of chronic pain with performed surgical interventions and injured anatomical parts of the body in patients with gunshot and mine- explosive wounds at the stages of treatment / Horoshko V.// Clinical and Preventive Medicine. – 2023. – №1(23). – 6-11. https://doi.org/10.31612/2616-4868.1(23).2023.01

10. Горошко В.Р. Інтенсивність болю пацієнтів під час реабілітації після мінно-вибухових поранень / Горошко В.Р., Кучин Ю.Л.// Біль, знеболення та інтенсивна терапія. – 2023. – №1 (102). – С. 26-30. DOI: 10.25284/2519- 2078.1(102).2023.278309

11. Horoshko V. Presence of a neuropathic pain component in patients with chronic pain after gunshot wounds / Horoshko V., Kuchyn Iu.// Clinical and Preventive Medicine. – 2023. – №2(24). – 14-20. https://doi.org/10.31612/2616-4868.2(24).2023.02

12. Horoshko V. Intensive care units during the Ukraine war: challenges and opportunities / Bielka K., Kuchyn I., Horoshko V.// Intensive Care Med. – 2023. https://doi.org/10.1007/s00134-023-07117-5

13. Horoshko V. Value of the number of injured anatomical partsof the body and surgeries for pain chronicityin patients with gunshot wounds and blast injuries / Horoshko V.// Emergency Medicine (Ukraine). – 2023. – 19(3). – 141-143. https://doi.org/10.22141/2224-0586.19.3.2023.1572

14. Горошко В.Р. Біль з нейропатичним компонентом у комбатантів після вогнепальних поранень / Горошко В.Р., Кучин Ю.Л.// Медична наука України. – 2023. – Т.19. – №1. С. 3-11. DOI: https://doi.org/10.32345/2664-4738.2.2023.02

15. Horoshko V. Microbial structure and sensitivity of pathogenic flora to antibiotics in patients with woundings of abdominal cavity / Kryshevskyi Y., Horoshko V., Khytryy G.// Emergency Medicine (Ukraine). – 2020. – 16(1). – 72–77. https://doi.org/10.22141/2224- 0586.16.1.2020.196932

16. Горошко В.Р. Результати лікування болю у військово-медичних клінічних центрах комбатантів після вогнепальних поранень / Горошко В.Р., Кучин Ю.Л.// Біль, знеболення та інтенсивна терапія. – 2023. – №2(103). – С. 37-43. DOI: 10.25284/2519- 2078.2(103).2023.284625

17. Horoshko V. Effectiveness of pain treatment for patients with mine-blast wounds depending on the number of localizations in military mobile hospitals / Kuchyn Iu., Horoshko V.// Clinical and Preventive Medicine. – 2023. – №3(25). – 39-44. https://doi.org/10.31612/2616-4868.3(25).2023.05

18. Horoshko V. Peculiarities of opioid analgesia management in patients with phantom pain after amputation of limbs due to gunshot wounds / Kuchyn I., Kuznecov A., Gybalo R., Slobodyanyuk A., Mervinskyyi N., Drach S., Horoshko V.// Emergency Medicine (Ukraine). – 2023. – 19(4). – 257–260. http://dx.doi.org/10.22141/2224-0586.19.4.2023.1593

19. Горошко В.Р. Особливості лікування болю у пацієнтів з вогнепальними пораненнями в лікарсько-сестринських бригадах / Горошко В.Р.// Медична наука України. – 2023. – Т.19. – №3. С. 17-22. DOI: https://doi.org/10.32345/2664- 4738.3.2023.03

20. Horoshko V. Quality of life and pain management in patients after gunshot wounds. / Horoshko V.// Clinical and Preventive Medicine. – 2023. – №4(25). 37-40. https://doi.org/10.31612/2616-4868.4(26).2023.05

21. Horoshko V. Effect of treatment anesthetic tactics on long-term pain management outcomes in patients with gunshot and mine blast wounds. / Horoshko V., 61 Kuchyn Iu.// World of medicine and biology. – 2024. – №1(87). 56-59. DOI: 10.26724/2079- 8334-2024-1-87-56-59

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