IN NEWBORNS AFTER CESAREAN SECTION TAKING INTO ACCOUNT THE METHOD OF PAIN RELIEF
https://doi.org/10.35266/2949-3447-2024-3-10
Abstract
The article presents the results of an open prospective randomized study with a comparative analysis of clinical examination data, laboratory and instrumental diagnostic methods, and dynamic observation to determine the optimal multimodal pain relief for patients with pain syndrome in the early recovery period. The study included 310 women after operative delivery, divided into three groups, and their newborns. In the primary group, cesarean section was performed under epidural anesthesia, and was prolonged for three days after the surgery; the comparison group had spinal epidural anesthesia and prolonged epidural anesthesia
for three days in the postoperative period; the control group had epidural anesthesia and nonsteroidal antiinflammatory drugs in the postoperative period. Epidural anesthesia with ropivacaine during operative delivery and the three-day postoperative period had a more pronounced analgesic effect compared to spinal-epidural anesthesia with bipuvacaine during labor and prolonged anesthesia with ropivacaine in the postpartum period, and compared to epidural anesthesia with ropivacaine during labor and the use of non-steroidal antiinflammatory drugs in the first three days of the postoperative period. Adequate pain relief and improvement of the psychoemotional state of women results in normal lactation, ensuring the formation of a close connection between mother and child, which has a beneficial effect on the condition of newborns. Prolonged epidural anesthesia does not have a negative effect on the newborn, reduces the level of anxiety and pain, lowers physiological weight loss, improves weight gain, accelerates adaptation to new living conditions, which ultimately leads to a reduction in the length of hospital stay.
About the Authors
R. I. Ilichev
Intensivist
Russian Federation
Russian Federation
V. T. Dolgikh
Федеральный научно-клинический центр реаниматологии и реабилитологии, Москва
Russian Federation
Russian Federation
Doctor of Sciences (Medicine), Professor, Honored Scientist of the Russian Federation, Chief
Researcher
A. N. Kuzovlev
Федеральный научно-клинический центр реаниматологии и реабилитологии, Москва
Russian Federation
Russian Federation
Doctor of Sciences (Medicine), Docent
A. A. Turitsa
Федеральный научно-клинический центр реаниматологии и реабилитологии, Москва
Russian Federation
Russian Federation
Candidate of Sciences (Medicine), Associate Professor
References
1. Narasimhulu D. M., Scharfman L., Minkoff H. et al. A randomized trial comparing surgeon-administered intraoperative transversus abdominis plane block with anesthesiologist-administered transcutaneous block // International Journal of Obstetric Anesthesia. 2018. No. 35. P. 26–32. https://doi.org/10.1016/j.ijoa.2018.04.007.
2. Yu H.-Y., Wang S.-Y., Quan C.-X. et al. Dexmedetomidine Alleviates Postpartum Depressive Symptoms following Cesarean Section in Chinese Women: A Randomized Placebo-Controlled Study // Pharmacotherapy. 2019. Vol. 39, no. 10. P. 994–1004. https://doi.org/10.1002/phar.2320.
3. Полушин Ю. C., Коростелев Ю. М., Вартанова И. В. и др. Болевой синдром после родов и его влияние на качество жизни // Анестезиология и реаниматология. 2015. Т. 60, № 2. С. 47–50.
4. Manou-Stathopoulou V., Korbonits M., Ackland G. L. et al. Redefining the perioperative stress response: a narrative review // British Journal of Anaesthesia. 2019. Vol. 123, no. 5. P. 570–583. https://doi.org/10.1016/j.bja.2019.08.011.
5. Акарачкова Е. С., Артеменко А. Р., Беляев А. А. и др. Материнский стресс и здоровье ребенка в краткосрочной и долгосрочной перспективе // РМЖ. Медицинское обозрение. 2019. Т. 3, № 3. С. 26–32.
6. Овечкин А. М. Послеоперационная боль: состояние проблемы и современные тенденции послеоперационного обезболивания // Регионарная анестезия и лечение острой боли. 2015. Т. 9, № 2. С. 29–39.
7. Minig L., Biffi R., Zanagnolo V. et al. Reduction of postoperative complication rate with the use of early oral feeding in gynecologic oncologic patients undergoing a major surgery: a randomized controlled trial // Annals of Surgical Oncology. 2009. No. 16. P. 3101–3110. https://doi.org/10.1245/s10434-009-0681-4.
8. Недашковский Э. В., Седых С. В., Закурдаев Е. И. Использование визуально-аналоговой шкалы при оценке выраженности болевого синдрома после кесарева сечения в зависимости от метода обезболивания // Анестезиология и реаниматология. 2016. Т. 61, № 5. С. 372–376.
9. Ma J., Martin R., Chan B. et al. Using Activity Trackers to Quantify Postpartum Ambulation: A Prospective Observational Study of Ambulation after Regional Anesthesia and Analgesia Interventions // Anesthesiology. 2018. Vol. 128, no. 3. P. 598–608. https://doi.org/10.1097/ALN.0000000000001979.
10. Kintu A., Abdulla S., Lubikire F. Postoperative pain after cesarean section: assessment and management in a tertiary hospital in a low-income counter // BMC Health Services Research. 2019. Vol. 19, no. 1. P. 68.
11. Levene J. L., Weinstein E. J., Cohen M. S. et al. Local anesthetics and regional anesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children: A Cochrane systematic review and meta-analysis update // Journal of Clinical Anesthesia. 2019. No. 55. P. 116–127. https://doi.org/10.1016/j.jclinane.2018.12.043.
12. Рязанова О. В., Александрович Ю. С., Горохова Ю. Н. Сравнительная оценка эффективности различных вариантов обезболивания после операции кесарева сечения // Вестник анестезиологии и реаниматологии. 2019. Т. 16, № 6. С. 54–59.
13. Бенян А. С., Нечаева М. В., Калинкина О. Б. и др. Особенности использования протоколов ускоренной реабилитации в акушерстве : обзор литературы // Пермский медицинский журнал. 2020. Т. 37, № 5. С. 61–78.
14. Заболотский Д. В., Рязанова О. В., Мамсуров А. С. и др. Варианты послеоперационной анальгезии при кесаревом сечении. Что выбрать? // Регионарная анестезия и лечение острой боли. 2013. Т. 7, № 3. С. 16–20.
15. Захарова И. Н., Бережная И. В., Санникова Т. Н. и др. Кесарево сечение и проблемы лактации у женщин // Медицинский совет. 2018. № 17. С. 22–29.
16. Киреев С. С. Боль и стресс у новорожденных : обзор литературы // Вестник новых медицинских технологий. 2016. Т. 23, № 4. С. 328–342.
17. Yang Z., Liu L., Mu J. et al. Local injection of dexamethasone helping to prevent lower back pain after epidural delivery analgesia // Experimental and Therapeutic Medicine. 2018. Vol. 16, no. 4. P. 3389–3394. https://doi.org/10.3892/etm.2018.6623.
18. Jin J., Peng L., Chen Q. et al. Prevalence and risk factors for chronic pain following cesarean section: a prospective study // BMC Anesthesiology. 2016. No. 16. P. 99. https://doi.org/10.1186/s12871-016-0270-6.
19. Nasir F., Sohail I., Sadiq H. et al. Local Wound Infiltration with Ropivacaine for Postoperative Pain Control in Caesarean Section // Cureus. 2019. Vol. 11, no. 9. P. 55–72. https://doi.or/10.7759/cureus.5572.
20. Рязанова О. В. Корреляция между применением обезболивания при родоразрешении и частотой послеродовой депрессии // Медицина: теория и практика. 2018. Т. 3, № 4. С. 172–179.
Review
For citations:
Ilichev R.I., Dolgikh V.T., Kuzovlev A.N., Turitsa A.A. IN NEWBORNS AFTER CESAREAN SECTION TAKING INTO ACCOUNT THE METHOD OF PAIN RELIEF. Vestnik SurGU. Meditsina. 2024;17(3):65-73. (In Russ.) https://doi.org/10.35266/2949-3447-2024-3-10
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