[Abdominal cross section space blockade as a component of the multimodal postoperative analgesia in patients after cesarean section: blockade efficiency analysis].

UNLABELLED: RESEARCH PURPOSE: To compare postoperative analgesia after Cesarean section with abdominal cross section space (ACSB) blockade in a combination with non-opioid analgesics versus conventional system anaesthesia. MATERIALS AND METHODS: 62 patients (2 groups of 31), after planned Cesarean section were included in this randomized research. In main group ACSB was used for postoperative analgesia, in control--a system anaesthesia. Research included pain assessment with visual-analogue scale (VAS) during rest and cough after spinal block regression and 12 and 24 hrs postoperatively. Additionally vital capacity of lungs changes was measured. RESULTS: In the main group VAS data in rest and at cough at stages 12 and 24 of h. after operation were significantly lower, than in control group. Vital capacity of lungs in this group was reliably higher at a stage of 24 h. CONCLUSION: ACSB in a combination with non-opioid analgesics provides high analgesia level without narcotic analgesics application, increases postoperative patients comfort after Cesarean section.

[Realization of Fast track surgery principles during cesarean section].

The aim of the study was to evaluate the efficiency of Fast Track Surgery (FTS) program application and determine the role of the anesthesiologist in its realization during planned Cesarean section. There were 2 randomized groups formed (basic and control), which contained 22 patients each. The groups were identical by all anthropometrical indicators. The FTS was applied in the basic group while the control group was led in traditional postoperative mode. The level of postoperative pain was estimated by Visual Analogue Scale (VAS) in rest and during cough 6, 12 and 24 hours after surgery, cortisol and glucose level dynamics, Baevskiy index, nausea and vomiting frequency, defecation and urination delay, presence of anxiety and weakness were assessed. The VAS and Baevskiy index were lower in the basic group during 12th and 24th hour of investigation, p < 0.05. There was no difference in dynamic cortisol levels in both groups. The values of cortisol levels didn't exceed those of presurgical levels. The tendency of hypoglycemia in control group that testified the prevalence of ketabolic proccesses was accompanied by weakness and orthostatic reactions. In both groups urination delay, nausea and vomiting were present. The obtained data proved the efficacy and safety of FTS during Cesarean section. The study shows that the decision of FTS has to be made by the anesthesiologist. It can improve perioperative conduction of patients and result in the promt stabilization of mother's condition after surgical intervention and result to the optimized contact with the child as well as reduce the period of hospital stay and decrease the expenses.