grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2024-183-2-68-75grekov-2399Research ArticleОБЗОРЫREVIEWSЭффективность местной анестезии зоны токарных ран при коррекции послеоперационного болевого синдрома в колоректальной онкохирургии: обзор литературы.The effectiveness of local anesthesia of the trocar wound area in the correction of postoperative pain syndrome in colorectal oncosurgeryhttps://orcid.org/0000-0002-8514-5377ЗахаренкоА. А.ZakharenkoA. A.

Захаренко Александр Анатольевич, доктор медицинских наук, доцент, зав. кафедрой онкологии ФПО, руководитель отдела онкохирургии

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

Zakharenko Alexander A., Dr. of Sci. (Med.), Associate Professor, Head of the Department of Oncology of the Faculty of Postgraduate Education, Head of the Department of Oncosurgery

6-8, L’va Tolstogo str., Saint Petersburg, 197022

9516183@mail.ruhttps://orcid.org/0000-0002-9927-5607ТенО. А.TenO. A.

Тен Олег Андреевич, кандидат медицинских наук, доцент кафедры хирургических болезней стоматологического факультета с курсом колопроктологии, научный сотрудник отдела онкохирургии

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

AuthorID: 937324

Ten Oleg A., Cand. of Sci. (Med.), Associate Professor of the Department of Surgical Diseases of the Faculty of Dentistry with the Course of Coloproctology, Research Fellow of the Department of Oncosurgery

6-8, L’va Tolstogo str., Saint Petersburg, 197022

AuthorID: 937324

ten888oleg@mail.ruhttps://orcid.org/0009-0007-9352-7627ЗверевП. В.ZverevP. V.

Зверев Павел Васильевич, студент лечебного факультета

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

Zverev Pavel V., Student of the Faculty of Medicine

6-8, L’va Tolstogo str., Saint Petersburg, 197022

pavelzv1@yandex.ruhttps://orcid.org/0009-0002-2036-9262ОрловаА. А.OrlovaA. A.

Орлова Александра Андреевна, врач-анестезиолог-реаниматолог отделения анестезиологии и реанимации № 2

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

Orlova Alexandra A., Anesthesiologist and Intensivist of the Department of Anesthesiology and Intensive Care № 2

6-8, L’va Tolstogo str., Saint Petersburg, 197022

aorlova_12@yandex.ruhttps://orcid.org/0000-0002-6313-5856ПолушинЮ. С.PolushinYu. S.

Полушин Юрий Сергеевич, академик РАН, профессор, зав. кафедрой анестезиологии и реаниматологии, руководитель Научно-клинического центра анестезиологии и реаниматологии

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

Polushin Yuri S., Academician of the Russian Academy of Sciences, Professor, Head of the Department of Anesthesiology and Intensive Care, Head of the Scientific and Clinical Center of Anesthesiology and Intensive Care

6-8, L’va Tolstogo str., Saint Petersburg, 197022

polushinyus@1spbgmu.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И. П. Павлова» Министерства здравоохранения Российской ФедерацииРоссияPavlov UniversityRussian Federation20241504202418326875Copyright © Захаренко А.А., Тен О.А., Зверев П.В., Орлова А.А., Полушин Ю.С., 20242024Захаренко А.А., Тен О.А., Зверев П.В., Орлова А.А., Полушин Ю.С.Zakharenko A.A., Ten O.A., Zverev P.V., Orlova A.A., Polushin Y.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/2399ВВЕДЕНИЕ

ВВЕДЕНИЕ. Выраженный болевой синдром – серьезная проблема послеоперационного периода. Несмотря на высокую частоту выполнения лапароскопических хирургических вмешательств по поводу колоректального рака, до сих пор нет общепринятой тактики наиболее эффективного периоперационного обезболивания у таких пациентов. Мультимодальная анальгезия – современный метод обезболивания, воздействующий на множество звеньев патогенеза болевого синдрома. Предложенная в качестве золотого стандарта при открытых колоректальных операциях торакальная эпидуральная анестезия как компонент мультимодальной анальгезии не показывает таких же положительных результатов в условиях лапароскопического колоректального вмешательства.

ЦЕЛЬ

ЦЕЛЬ. Сравнить различные методики местной анестезии и определить наиболее перспективный в плане эффективности и доступности в повседневной практике метод местного обезболивания как компонент мультимодальной анальгезии.

МЕТОДЫ И МАТЕРИАЛЫ

МЕТОДЫ И МАТЕРИАЛЫ. С целью поиска и оценки применимости различных методов местной анестезии был проведен обзор современной научной литературы.

ВЫВОДЫ

ВЫВОДЫ. Инфильтрация раствора местного анестетика в зону трокарных ран – наиболее простой и доступный метод анестезии, сравнимый по эффективности с другими методами локорегионарного обезболивания, который может быть перспективным компонентом мультимодальной анальгезии в колоректальной онкохирургии.

INTRODUCTION

INTRODUCTION. Severe pain syndrome is a significant complication of the postoperative period. Despite the prevalence of laparoscopic surgical interventions for colorectal cancer, there is still a lack of commonly agreed strategies to provide the most effective perioperative analgesia in such patients. Multimodal analgesia is a modern method of anesthesia that affects multiple components of the pathogenesis of pain syndrome. Proposed as a gold standard for open colorectal surgeries, thoracic epidural anesthesia as a component of multimodal analgesia does not show the same beneficial results in laparoscopic colorectal intervention.

The OBJECTIVE was to compare different techniques of local anesthesia and to identify the most perspective method of local anesthesia as a part of a multimodal analgesia in terms of effectiveness and affordability in daily practice.

METHODS AND MATERIALS

METHODS AND MATERIALS. A review of the current scientific literature was conducted in order to search and assess the usability of different local anesthesia techniques.

CONCLUSION

CONCLUSION. Infiltration of a local anesthetic solution into the trocar wound area is the most uncomplicated and affordable method of anesthesia, comparable in efficacy with other methods of locoregional anesthesia, which can potentially be a promising component of multimodal analgesia in colorectal oncosurgery.

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The authors declare that there are no conflicts of interest present.