Choosing a method of analgesia of the anterior abdominal willin patients after surgical delivery
- Authors: Ilichev R.I.1, Kuzovlev A.N.1, Dolgikh V.T.1
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Affiliations:
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitololgy
- Issue: Vol 36, No 9 (2025)
- Pages: 5-12
- Section: Topical Subject
- URL: https://journal-vniispk.ru/0236-3054/article/view/315144
- DOI: https://doi.org/10.29296/25877305-2025-09-01
- ID: 315144
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Abstract
Objective. The research goal was to substantiate the optimal choice of multimodal anesthesia of patients in the early recovery period after operative delivery to improve rehabilitation, reduce complications and improve the quality of life of parturient women and newborns.
Materials and methods. An open-label prospective randomized research was held, during which the data of clinical examination, the results of laboratory and instrumental methods of diagnosis and dynamic observation of 310 parturient women and newborns were analyzed. Patients and newborns were divided into three groups. In the main group (n=112), cesarean section was performed for parturient women under epidural anesthesia, which was prolonged in the first three days of the postoperative period. In the comparison group (n=95), the operation was performed under combined spinal-epidural anesthesia, and prolonged epidural anesthesia was used in the first three days of the postoperative period. In the control group (n=103), the operation was performed under epidural anesthesia, and in the postoperative period, nonsteroidal anti-inflammatory drugs (NSAIDs) were used for anesthesia.
Results. It was found that the combination of epidural anesthesia during labor and prolonged epidural anesthesia with ropivocaine in the first three days after cesarean section has a stronger analgesic effect compared to the combination of combined spinal-epidural anesthesia of bipuvacaine during labor and prolonged anesthesia of ropivocaine in the postpartum period, as well as in comparison with the combination of epidural anesthesia of ropivocaine in labor and NSAIDs in the first three days of the postoperative period. Prolonged epidural anesthesia significantly reduced stress hormone levels in both the mother and the newborn during the first 24 hours after surgery and had no negative effects on the newborn.
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##article.viewOnOriginalSite##About the authors
R. I. Ilichev
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitololgy
Email: prof_dolgih@mail.ru
ORCID iD: 0009-0002-4420-2440
SPIN-code: 9728-2833
Russian Federation, Moscow
A. N. Kuzovlev
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitololgy
Email: prof_dolgih@mail.ru
ORCID iD: 0000-0002-5930-0118
SPIN-code: 8648-3771
MD
Russian Federation, MoscowV. T. Dolgikh
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitololgy
Author for correspondence.
Email: prof_dolgih@mail.ru
ORCID iD: 0000-0001-9034-4912
SPIN-code: 2052-1445
Professor, MD
Russian Federation, MoscowReferences
- 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; 39 (10): 994–1004. doi: 10.1002/phar.2320
- Tamura T., Yokota S., Ando V. et al. A triple-blinded randomized trial comparing spinal morphine with posterior quadratus lumborum block after cesarean section. Int J Obstet Anesth. 2019; 40: 32–8. doi: 10.1016/j.ijoa.2019.06.008
- Macones G.A., Caughey A.B., Wood S.L. Guidelines for postoperative care in cesarean delivery: Enhanced Recovery After Surgery (ERAS) Society recommendations (part 3). Am J Obstet Gynecol. 2019; 221 (3): 247.e1-247.e9. doi: 10.1016/j.ajog.2019.04.012
- Manou-Stathopoulou V., Korbonits V., Ackland G.I. Redefining the perioperative stress response: a narrative review. Br J Anaesth. 2019; 123 (5): 570–83. doi: 10.1016/j.bja.2019.08.011
- 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. J Clin Anesth. 2019; 55: 116–27. doi: 10.1016/j.jclinane.2018.12.043
- Багомедов Р.Г., Омарова Х.М. Различные виды анестезии при операции «кесарево сечение» (обзор литературы). Вестник новых медицинских технологий. 2015; 22 (1): 87–93 [Bogomedov R.G., Omarova Kh.M. Various types of anesthesia during caesarean section (literature review). Vestnik novikh medicinskikh trkhnologiyi. 2015; 22 (1): 87–93 (in Russ.)]
- Шейбак Л.Н. Современные подходы к диагностике гипогликемии у новорожденных. Медицинские новости. 2016; 6: 25–8 [Sheibak L.N. Modern approaches to the diagnosis of hypoglycemia in newborns. Medicinskie novosti. 2016; 6: 25–8 (in Russ.)]
- Таштанбекова Ч.Б., Чуенкова Е.А., Евстратов А.А. и др. Управление болью при кесаревом сечении: использование и стоимость анестетиков и анальгетиков. Казанский медицинский журнал. 2020; 101 (3): 418–25 [Tashtanbekova C.B., Chuenkova E.A., Evstratov A.A., et al. Use and costs of pain management in cesarian section. Kazan medical journal. 2020; 101 (3): 418–25 (in Russ.)]. doi: 10.17816/KMJ2020-418
- Овечкин А.М. Послеоперационное обезболивание в акушерстве и гинекологии (аналитический обзор). Регионарная анестезия и лечение острой боли. 2014; 8 (2): 5–16 [Ovechkin A.M. Postoperative analgesia in obstetrics and gynecology: foreign guidelines and our reality. Regional Anesthesia and Acute Pain Management. 2014; 8 (2): 5–16 (in Russ.)]. doi: 10.17816/RA36203
- Aly M., Ibragim A., Farrag W. et al. Pruritus after intrathecal morphine for cesarean delivery: incidence, severity and its relation to serum serotonin level. Int J Obstet Anesth. 2018; 35: 52–6. doi: 10.1016/j.ijoa.2018.02.004
- Лядов К.В., Коваленко З.А., Лядов В.К. и др. Опыт внедрения программы ускоренной послеоперационной реабилитации (fast track) в хирургической панкреатологии. Вестник восстановительной медицины. 2014; 5: 21–5 [Lyadov K.V., Kovalenko Z.A., Lyadov V.K. et al. Fast track recovery pathways in pancreatic surgery. Bulletin of Rehabilitation Medicine. 2014; 5: 21–5 (in Russ.)]
- Фомин С.А., Александрович Ю.С., Фомина Е.А. Эволюция подходов к оценке боли у новорожденных. Неонатология: новости, мнения, обучение. 2018; 7 (1): 47–59 [Fomin S.A., Aleksandrovich Yu.S., Fomina E.A. Evolution of approaches to evaluation pain in newborns. Neonatology: News, Opinions, Training. 2018; 7 (1): 47–59 (in Russ.)]. doi: 10.24411/2308-2402-2018-00007
- Carvalho B., Butwick A.J. Post-Cesarean Delivery Analgesia. Best Pract Res Clin Anaesthesiol. 2017; 31 (1): 69–79. doi: 10.1016/j.bpa.2017.01.003
- Lee T.H., Qu Y., Telzer E.H. Dyadic neural similarity during stress in mother–child dyads. J Res Adolesc. 2018; 28 (1): 121–33. doi: 10.1111/jora.12334
- Овечкин А.М. Послеоперационная боль: состояние проблемы и современные тенденции послеоперационного обезболивания. Регионарная анестезия и лечение острой боли. 2015; 9 (2): 29–39 [Ovechkin A.V. Postoperative pain: the state of problem and current trends in postoperative analgesia. Regionarnaya anesteziya i lechenie ostroy boli. 2015; 9 (2): 29–39 (in Russ.)].
- Izadpanah A., Soorgi A., Geraminejad N. et al. Effect of grape seed extract ointment on cesarean section wound healing: A double-blind, randomized, controlled clinical trial. Complement Ther Clin Pract. 2019; 35: 323–8. doi: 10.1016/j.ctcp.2019.03.011
- Maple H., Chilcot J., Lee V. et al. Stress predicts the trajectory of wound healing in living kidney donors as measured by high-resolution ultrasound. Brain Behav Immun. 2015; 43: 19–26. doi: 10.1016/j.bbi.2014.06.012
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