Evaluation of preventive analgesia for emergency operations on the abdominal organs in children

The problem of post-operative analgesia effectiveness remains relevant especially for children. Pain management in children is often inadequate. The scheme of antinociceptive therapy with the acetaminophen liquid form has been optimized in order to increase the effectiveness of the acute pain relief after emergency laparoscopic surgery in children. Analysis of the results of intravenous form of paracetamol use in 64 children with acute surgical diseases of abdominal cavity underwent emergency laparoscopic procedures has been carried out. The high antinociceptive effect of the proposed scheme of preventive analgesia has been proved. The children premedication with paracetamol does not exert the suppressive effect on the central nervous system functions, requires no changes of the anesthesia standard scheme for laparoscopic surgery, does not lead to the extension of the anesthetics depressive effect on the central nervous system function, as demonstrated by monitoring the electrical activity of the cerebral cortex (BIS). Evidence of positive effect of the paracetamol use during the operational stress has been found. The scheme of preventive analgesia using the liquid form of acetaminophen can be recommended for widespread use in emergency surgery.

1. Kiriyenko P.A., Shiryaev M.I., Victorov A.A., Gel'fand B.R. Postoperative pain and analgesia: case studies of preparations including paratsetamol // Consilium Medicum. 2006. 8. (1). 12-16. (in Russian)
2. Ovechkin A.M. Postoperative pain: clinical and pathophysiological significance and future directions of therapy // Consilium Medicum. 2005. 7. (6). 486-490. (in Russian)
3. Osipova N.A., Petrov V.V., Donskova Y.S. Place of paracetamol (Perfalgan) in multimodal postoperative analgesia // Russkiy meditsinskiy zhurnal. 2006. 14. (28). 2009-2014. (in Russian)
4. Elia N., Lysakowski C., Tramer M.R. Concomitant use of non-opioid analgesics and morphine after major surgery - is there a clinically relevant morphine sparing effect? A meta-analysis of randomized trials // Eur. J. Anaesthesiol. 2005. 22 (Suppl. 34). 186. A-726.
5. Hay A.D., Redmond N., Fletcher M. Antipyretic drugs for children // BMJ. 2006. 333. (7557). 4-5.
6. Postoperative Pain Management - Good Clinical Practice. General recommendations and principles for successful pain management. Produced with the consultations with the Europeans Society of Regional Anaesthesia and Pain Therapy. Project chairman N. Rawal, 2005. 57 p.

Stepanov A.V. - postgraduate student
Smagin A.A. - doctor of medical sciences, professor, head of laboratory of the lymphodetoxication
Morozov V. V. - doctor of medical sciences, professor, senior researcher, e-mail: doctor.morozov@ mail.ru