METHOD OF PROPHYLAXIS OF POST-TRAUMOTOMIC PAIN SYNDROME IN ONCOSURGERY Russian patent published in 2017 - IPC A61K31/197 A61K31/137 A61K31/445 A61K31/4468 A61P23/00 A61P29/00 

FIELD: medicine.

SUBSTANCE: for the prevention of post-thoracotomy pain syndrome (hereinafter - PTPS) in oncosurgery a day before the surgery, anticonvulsant pregabalin is administered orally 75 mg 2 times/day and 75 mg 2 hours before the operation. Then, an epidural catheter is performed on the operating table, through which a three-component mixture is infused throughout the operation: ropivacaine 3 mg/ml+fentanyl 4 mcg/ml+epinephrine 2 mcg/ml at a rate of 5-15 ml/h. Induction of anesthesia is intravenously: fentanyl 0.00004±0.00002 mg/kg, ketamine 0.29±0.13 mg, propofol 0.56±0.31 mg/kg, rocuronium bromide 0.68±0.14 mg/kg. Maintenance of anesthesia: sevoflurane inhalation 0.6-1 MAK in an oxygen-air mixture (FiO₂ 0.3-0.8), fentanyl 0.00004±0.00002 mg/kg/h, ketamine 0.0013±0.0002 mg/kg/hour. 40 minutes before the end of the operation, nefopam is administered with 20 mg IM. In the postoperative period, infusion is performed in the epidural space: ropivacaine 2 mg/ml+fentanyl 4 mcg/ml+epinephrine 2 mcg/ml, injection rate 4-6 ml/h for 2 days. Then, the mixture reduces the concentration of ropivacaine to 0.2% and continues infusion to 5-7 days, at a rate of 4-6 ml/h. At occurrence of the first complaints on painful sensations prescribe nefopam of 20 mg im/m and continue its appointment in a dose of 20 mg 2 times a day for 5 days and lornoxicam 8 mg intravenously - 2 times/day and pregabalin 75 mg orally - 2 times/day for 5 days. In case of ineffectiveness of this therapy, morphine is prescribed 10 mg IM.

EFFECT: invention allows to reduce the frequency of development of acute PTPS, its intensity, to reduce the postoperative need for opioid analgesics and to reduce the frequency of development of chronic PTPS.

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