[Insomnia and its treatment during the postoperative period]. / Problema bessonnitsy i ee lechenie u bol'nykh v posleoperatsionnom periode.

A total of 108 patients have filled in questionnaires on falling asleep, sleeping, night awakenings and other characteristics. Their answers have been analysed and it was concluded that night sleep of patients especially in the postoperative period was characterized by prolonged period of falling asleep (over 30 min in 50% of patients), reduced duration, in 77% of patients night awakenings have been recorded. The use of analgin (1000 mg) in combination with dimedrol (10 mg), promedol (20 mg) for tramal (100 mg) for normalization of sleep in the postoperative period was of little efficacy. Therapy of night sleep disturbances will improve the patients' condition and enhance the efficacy of management after surgical interventions.

[Analysis of the work of an analgesia service in an outpatient clinic]. / Analiz raboty poliklinicheskogo protivobolevogo kabineta.

The management of patients with chronic pain syndrome in out-patient clinics is a new form of specialized therapy. 347 cancer patients were treated using a modified "analgetic staircase" technique (14% of them at home), with an analgetic effect achieved in 60-70% of cases. The patients with pain syndrome were managed using sacral, epidural and subarachnoidal neurolysis blockades.

[Economic aspects of the treatment of acute and chronic pain syndromes in cancer patients in hospitals and outpatient clinics]. / Ekonomicheskie voprosy lecheniia ostrogo i khronicheskogo bolevykh sindromov u onkologicheskikh patsientov v statsionare i poliklinike.

Cost of treatment of pain in 1687 hospital and 400 ambulatory cancer patients was calculated. The average cost of medication for acute pain in a hospital was 1.41 roubles per conventional patient whereas for chronic pain in a polyclinic--4.31 roubles. The overall expenses were 82.55 and 18.81 roubles per conventional patient, respectively. Those expenses were formed by the cost of drugs (1.71% and 22.91%, respectively), salary (deductions included) for medical (36.92% and 61.24%) and other staff (37% and 5.8%), wear and tear (0.61% and 0.21%) and running costs (23.76% and 8.84%, respectively).

[The cost of postoperative drug analgesia of patients with cancer]. / Stoimost' medikamentoznoi analgezii v posleoperatsionnom periode u onkologicheskikh bol'nykh.

Calculation of expenses on drug analgesia based on 1687 case records of cancer patients with different tumour location (lung, esophageal, gastric, rectal, uterine and breast cancer) has revealed different structure of expenditure on days 1 to 3 of the postoperative period. On the day of surgery, 44% on average were spent on narcotic analgesics and 37% on analgin, on the 2nd and 3rd days postoperatively the ratio was 31 and 35% and 25 and 28% respectively, which to a certain extent indicates changes in postoperative pain intensity in cancer patients. The expenses on narcotic analgesics and analgin during those days were 31 and 68% of the total sum, respectively, which in absolute figures was 1 rouble 4 kopecks per patient on average. Estimation of expenses on drug analgesia in cancer patients during the first 3 days after radical surgery make it possible for the physicians to better understand the proportions of such expenditures in the budget of medical institutions.

[The readaptation problems of cancer patients]. / Nekotorye problemy readaptatsii onkologicheskikh bol'nykh.

The paper discusses certain problems involved in communication between physician, cancer patient and society. The authors suggest that information given to a cancer patient on his or her diagnosis should be determined by the patient's willingness to know and prognosis. Also, suggestions on improvement of treatment of cancer patients of clinical group 4 are made.

[Pain syndrome in cancer patients after lung and breast surgery]. / Bolevoi sindrom u onkologicheskikh bol'nykh posle operatsii na legkikh i molochnoi zheleze.

Analysing, the results of questionnaires offered to cancer patients on days 1 and 2 after lung (50 males) and mammalian (50 females) surgery more detailed clinical structures of acute pain syndrome have been identified. Different pain syndromes develop after intra- and extrathoracic surgery. They are characterized by distinct intensity, maximum pain onset, pain irradiation and concomitant events. The detailed clinical structure of these acute pain syndromes described allowed of a more directed effective antinociceptive therapy establishing "analgetic comfort" in the postoperative period.

[Analgesic therapy of cancer outpatients]. / Protivobolevaia terapiia u onkologicheskikh bol'nykh v ambulatornykh usloviiakh.

The results of treatment of 164 out-patients with far advanced malignancies for chronic pain syndrome are discussed. It was found that subarachnoid, peridural and sacral blocks with alcohol, phenol glycerine and carbolic acid can relieve pain for a long time, improve general condition and save narcotic analgetics. The most effective proved to be peridural block by phenolglycerine which induced analgesia in 67% of cases and maintained it for 45 days.

[Structure of acute and chronic pain syndromes in patients with gynecologic tumors]. / Struktura ostrogo i khronicheskogo bolevykh sindromov u onkoginekologicheskikh bol'nykh.

Questionnaires on the nature of pain were distributed among 100 female postoperative and 29 incurable patients suffering from genital tumors. The structure of an acute and a chronic pain syndrome was established. The postoperative pain syndrome appeared to be determined, mainly, by the site and extent of surgical intervention while the chronic one by the pattern of tumor progression.

[Effect of analgesics on the growth and metastasis of sarcoma 37]. / Vliianie nekotorykh anal'getikov na rost i metastazirovanie sarkomy 37.

Treatment with such analgetics as analginum, promedol and pantopon was shown experimentally either to inhibit or to stimulate the growth of sarcoma-37 and its dissemination. It was also found to reduce the tumor growth--stimulating effect of operative trauma.

[Elimination of the pain syndrome in patients with generalized forms of malignant genital tumors]. / Ustranenie bolevogo sindroma u bol'nykh generalizovannymi formami zlokachestvennykh opukolei genitalii.

The structure of chronic pain and its treatment in 41 cases of advanced malignant tumor of genitals are discussed. Pain syndrome was found to have a certain pattern (site, acuteness, depth, irradiation) which may be used as an additional diagnostic parameter. Different types of analgetic blockade (neurolysis) e. g. subarachnoidal, peridural and sacral, as well as blockade of pudendal nerve were applied in the treatment. Subarachnoidal blockade by alcohol proved to be the most effective (78%) and lasting (22 days). Analgesia by sacral blockade is less effective but safer.

[Relapse symptom complex in rectal cancer after radical surgical interventions]. / Simptomokompleks retsidivov u bol'nykh rakom priamoi kishki posle radikal'nykh operativnykh vmeshatel'stv.

The analysis of 78 questionnaires of patients with recurrence of rectal cancer was performed which revealed this complication of surgery to occur in 60% of cases within a year after operation. Recurrences of the rectum cancer show a characteristic complex of symptoms with a certain structure of painful sensations as a central criterion.