Medical Perspectives-Medicni Perspektivi最新文献

{"title":"Сhronic relapsing inflammatory optic neuropathy: diagnostic strategies and treatment (literature review)","authors":"T. Nehrych, M. Kopchak, S. Kyryliuk","doi":"10.26641/2307-0404.2023.2.283157","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283157","url":null,"abstract":"The article presents a review and analysis of scientific works on the problem of chronic relapsing inflammatory optic neuropathy, its diagnostic criteria and treatment methods. Chronic relapsing inflammatory optic neuropathy, first described in 2003, is an autoimmune inflammatory disease of the optic nerve of unknown etiology, accompanied by frequent painful episodes of optic neuritis, with a clear response to steroid therapy and relapses after its withdrawal. An analysis of foreign works published in the E-Library, CrossRef, PubMed, Web of Science, Scopus databases was carried out in order to systematize data on the etiology, pathogenesis, clinical manifestations, diagnostic criteria, differential diagnosis and treatment of this pathological condition. It has been established that chronic recurrent inflammatory optic neuropathy is a rare, recurrent, corticosteroid-dependent optic neuropathy in which there is no other neurological deficit, no etiological factor is identified and it is a diagnosis of exclusion. It is important to identify such patients because the appointment of appropriate immunosuppressive therapy causes remission of the disease.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"7 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87947045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical and social factors of delinquency in children with pervasive neurodevelopmental disorders","authors":"L. Bratkova, G.F. Kryvda, M. Stoieva, R. G. Kryvda, M. Fedin, T. Godlevska","doi":"10.26641/2307-0404.2023.2.283354","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283354","url":null,"abstract":"Recently, a number of delinquencies with children and adolescents increases. Currently, numerous sociopsychological factors of deviant behavior have been  identified. At the same time, modern research of delinquency is also focused on the study of medical prerequisites for the deviant behavior development, such as the presence of mental diseases that cause low intelligence, a tendency to auto-aggression and extra-aggression, emotional insensitivity and asociality. Until now, medical aspects of delinquency have been mainly focused on psychosocial factors and psychiatric nosologies. However, such an important factor as the general somatic health of the child is often not taken into account. Despite the high frequency of somatic morbidity in children with autism spectrum disorders (such as: gastrointestinal functional disorders, allergic diseases, metabolic disorders), the role of psychosomatic factors and comorbid conditions and their association with delinquency is still undetermined. The aim is to determine the structure of delinquency and the importance of psychosomatic factors in the formation of externalizing disorders in children and adolescents with neurodevelopmental disorders, which was conducted with the participation of 32 children aged 2 to 11 (7.3±0.5) years. It was established that changes in the cog­nitive (56.2±7.0%) and emotional (62.5±8.6%) spheres prevail in the structure of psycho-behavioral disorders of children with neurodevelopmental disorders. A significant role in the formation of externalizing disorders is played by concomitant somatic pathology, which is characterized by a tendency to process chronification, disturbs the quality of life, and negatively affects emotional and volitional indicators. An integrated assessment of social, psychological, pedagogical and medical factors of delinquency is the key to effective correction and prevention of behavior disorders in children.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"3 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78724224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Important professional qualities of patient safety specialists","authors":"M. Rygan, O. P. Yavorovskyi, R.P. Bruкhno, Y. Skaletskyi, M.I. Badyuk M.I., T. Zinchenko, E.M. Anisimov, N. D. Kozak, N.V. Ustiak, Y. Kudiievskyi","doi":"10.26641/2307-0404.2023.2.283413","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283413","url":null,"abstract":"The study of individual characteristics of the patient safety culture was conducted in various Ukrainian health care facilities using the questionnaire of the Agency for Healthcare Research and Quality's (AHRQ). The characteristics of the patient safety culture were analyzed by taking into account the length of service, membership of respondent to medical or nursing staff, and the profile of therapeutic or surgical activity. The essential professional qualities of patient safety specialists and the categories of persons who are the most suitable candidates for the training of patient safety specialists were defined. It was noted that training specialists to ensure patients safety, taking into account professionally essential qualities, becomes especially relevant in connection with the transition from the culture of blaming individuals for mistakes to the practice of a fair culture, in which mistakes are not considered as a personal oversight, but as an opportunity to improve the system and prevent future harm. It was found that the nursing staff rated patient safety on wards lower than in hospital. A greater risk of adverse event reporting was found for surgical workers and a reduced risk of adverse event reporting for workers with 21 years of experience or more compared to workers with five years of experience or less. Based on the conducted research, it was concluded that the most suitable candidates for training patient safety specialists would be surgeons with 5 years of experience, who are critical as for patient safety in their units and prone to disclose adverse events.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"90 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83914998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural and functional condition of the heart in patients with arterial hypertension depending on A1166C-gene polymorphism of angiotensin II type 1 and T786C-promoter of endothelial NO-synthase gene","authors":"R.V. Hnizdiukh, V. Shmanko","doi":"10.26641/2307-0404.2023.2.283252","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283252","url":null,"abstract":"It's known that pathological changes in structural and functional condition of the heart, which are caused by arterial hypertension, trigger development of chronic heart failure and disablement of population. Nowadays, it proven that candidate genes, expression products of which participate in regulating vascular tone, have considerable influence upon development of arterial hypertension, however their role in pathogenesis of arterial hypertension has not been fully clarified, and results of the respective researches significantly vary among different populations. To determine the structural and functional state of the heart in patients with hypertension depending on the polymorphism of the A1116C gene of the angiotensin II receptor type I and the T786C promoter of the endothelial NO-synthase gene we examined 86 patients, aged from 45 to 76 years. 30 people without signs of hypertension were in the control group. The structural and functional state of the heart was assessed by cardiac ultrasound according to standard methods. Studies of the A1166C allelic polymorphism of the angiotensin II receptor gene type 1 and the T786C promoter of the eNOS gene were performed by polymerase chain reaction with electrophoretic detection of results. Analysis of cardiac ultrasound showed, that in the patients – carriers of C-allele of both studied genes (AС+СС and TC+CC) left ventricular ejection fraction tended to decrease. We found a bigger thickness of the posterior wall of the left ventricle in patients with CC genotype compared to carriers of AA genotype A1166C – (1.3±0.07) cm vs. (1.1±0.05) cm (p<0.005). The mass of the left ventricular myocardium index in the group of patients with the genotype AC and CC was (157.5±7.3) g/m2 and (161.5±7.1)) g/m2, respectively, being by 16.7% and 19.6% more than in carriers of AA genotype of the AGTR1 gene. In the groups of patients-carriers of C-allele (TC+CC) of the eNOS gene the mass of the left ventricular myocardium index values were (155.2±11.4)) g/m2 and (158.4±7.9)) g/m2, respectively, which is by 5.4% and 7.5% more than in carriers of TT genotype. The mean size of the left atrium was significantly higher in patients who had AC and CC genotype of the AGTR1 gene, as well as TC and CC genotype of the eNOS gene compared with the control group. Carriers of C-allele (AC+CC genotype) of AGTR1 gene polymorphism had clearly bigger sizes of the left atrium, as compared to homozygotes by A-allele. The severity of diastolic dysfunction was higher in carriers of the CC genotype of the AGTR1 gene and the eNOS gene than in heterozygotes of the studied genes by 4.3% and 3.3%, respectively. The research shows that inheritance of CC genotype for A1166C polymorphism of the the angiotensin II type 1 receptor gene and of CC T786C polymorphism in the promoter of eNOS gene is associated with more noticeable changes in structural and functional heart condition among patients with arterial hypertension.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"52 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86459363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and depression in patients with multiple sclerosis","authors":"O. Somilo, S. Makarov, O. Kalbus, A. V. Sorokin","doi":"10.26641/2307-0404.2023.2.283349","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283349","url":null,"abstract":"Multiple sclerosis is a chronic progressive inflammatory autoimmune disease of the central nervous system. This disease mainly affects young females and leads to disability of the patient, which causes a significant socio-economic burden which this disease causes. Clinically, multiple sclerosis is characterized by a wide variety of neurological and neuropsychological manifestations: movement disorders, sensory disturbances and cognitive dysfunction. One of the most typical psycho-emotional disorders that occur in patients with multiple sclerosis are anxiety and depression. The article is devoted to the study of the features of these disorders in patients with multiple sclerosis. The purpose of the study is to evaluate and characterize psycho-emotional disorders in patients with relapsing-remitting multiple sclerosis. The study included 105 patients with relapsing-remitting multiple sclerosis who underwent inpatient treatment in the Department of Neurology No. 1 Municipal Institution “Dnipropetrovsk Regional Clinic Hospital named after I.I. Mechnykov\" Dnipropetrovsk Regional Council\". Among the patients included in the study, there were 74 women (70.5%) and 31 men (29.5%). The largest proportion of those surveyed falls on the age group from 25 to 40 years – 80 (76.2%). All participants were assessed according to the generally accepted scale for multiple sclerosis patients assessment – Expanded Disability Status Scale (EDSS). All study participants were divided into two groups – group 1 and group 2 – according to the degree of disability according to EDSS. Considering that the degree of disability according to EDSS≤3.5 is defined as mild, and most patients had just this level, they were assigned into group 1, patients with a score of 3.5&lt;EDSS≤6.5 points were assigned to group 2 with a moderate degree of disability. The number of participants in group 1 was 73 patients (69.5%), group 2 – 32 (30.5%). The psychoemotional sphere was assessed using validated psychodiagnostic tests: Beck Depression Inventory and the State-Trait Anxiety Inventory. The average level of depression, determined by Beck Depression Inventory, was 16.0 (13.0; 18.0) points among all examined, in patients of the 1st group – 14.0 (11.0; 16.0) points, while in patients of the 2nd group it was significantly higher (p&lt;0.001) and amounted to 19.0 (19.0; 24.5) points. Assessment of the level of anxiety according to State-Trait Anxiety Inventory showed that in the majority of patients (84.8%) the level of reactive anxiety was moderate (31-44 points) and made up 36.0 (34.0; 39.0) points. Indicators of personal anxiety in most cases (69.5%) were low (up to 30 points) and averaged 27.0 (24.0; 31.0) points. It should be noted that the level of reactive anxiety exceeded the level of personal anxiety in the study groups and in general among all examined (p&lt;0.001 for all comparisons). Anxiety and depression are very common psychoemotional disorders in patients with relapsing-remitting multiple ","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"16 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87924039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of physical therapy and occupational therapy in palliative and hospice medicine (review)","authors":"О. Raznatovska, S.M. Kanygina, R. M. Yasinskyi, A. Fedorec, O. Svitlytska","doi":"10.26641/2307-0404.2023.2.283161","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283161","url":null,"abstract":"Higher level of functional incapacity and invalidity is noted in palliative patients, as a result of disease progression,  which is the reason for a significant decrease in the quality of life not only of these patients, but also of the family members who care for them. Physical therapy and occupational therapy are aimed at improving the patient's quality of life through rehabilitation measures to restore body function, ensure physical independence and activity, optimal physical condition and well-being, and patient adaptation in the environment. Aim: to review modern literary sources regarding the relevance of physical therapy and occupational therapy in palliative and hospice care. The search for literary sources was carried out in international scientometric databases: PubMed, Scopus, Web of Science, Google Scholar. The search depth is 13 years (from 2010 to 2022). The review indicates that physical therapy and occupational therapy in palliative and hospice medicine around the world are not used enough today. These two specialties of interdisciplinary treatment in palliative and hospice medicine play an important integral role, which is manifested in improving the quality of life of both patients and their family members who care for them through the use of a wide variety of methods. Hospice physical therapists not only help patients to support/keep functional abilities as long as possible, but also to reduce the burden on persons who care for terminally ill patients. Physical and occupational therapy have numerous benefits for patients with progressive life-threatening illnesses in palliative and hospice care. Physical therapy in palliative and hospice care can have a preventive, educational, and/or supportive function depending on the patient's situation. There is especially large deficiency in palliative physical therapy and occupational therapy among adolescents and young people, which requires wide implementation with high-quality training of relevant specialists. Physical therapy and occupational therapy play an important role in palliative and hospice care; all patients in palliative and hospice care, regardless of illness or severity, should have access to physical and occupational therapy based on individual needs.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"1220 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76811341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ways to promote the efficiency of herpetic stomatitis treatment","authors":"R. Lutsenko, N. Moisieieva, A. Sydorenko, H.Yu. Ostrovska, A. A. Kapustianska","doi":"10.26641/2307-0404.2023.2.283255","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283255","url":null,"abstract":"The treatment of herpetic stomatitis should be etiotropic, pathogenetic, symptomatic, and local. The research determined the effectiveness of inosine pranobex (1000 mg 4 times a day) in herpetic stomatitis treatment. Addition of inosine pranobex to the pharmacotherapy of herpetic stomatitis reduced hospital stay and duration of treatment. The drug suppresses the synthesis of the virus due to the structure of inosinic acid in the polyribosomes of the cell affected by the virus, and also helps to eliminate the deficiency or dysfunction of immunity that occurred in the case of herpetic stomatitis, it affects the activity of T-cytotoxic lymphocytes and natural killers, enhances the action of neutrophil granulocytes, chemotaxis and phagocytosis of monocytes and macrophages, increases the synthesis of interleukins IL-1 and IL-2, affects the number of Ig G immunoglobulins. Applying inosine pranobex also significantly decreased pain syndrome manifestations from the start of the treatment. It contributed to body temperature normalization 2 days earlier which shortened the treatment period at the in-patient department. Applying inosine pranobex in the combination therapy of herpetic stomatitis has shown a potent clinical efficacy and can be an alternatіve to acyclic nucleosides in patients with herpetic stomatitis of the oral mucosa.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"92 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90269113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking prevalence among adults in households with children: parental survey","authors":"O. Starets, D. Kovalenko","doi":"10.26641/2307-0404.2023.2.283396","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283396","url":null,"abstract":"The effects of tobacco smoke and nicotine on the health of adults and children remain one of the most burning problem in our days. In 2019 the prevalence of active smoking in Ukraine reached 42.0 among men and 14.4% among women. The negative effects of second-hand tobacco smoke exposure are most significant in children under 5 years of life, especially in families with smoking mothers. The goal of the study was to assess the current smoking prevalence in families with children, including the use of modern electronic nicotine delivery devices. A self-reported survey of 414 families living in Odessa and Odessa region (Ukraine) was conducted. All questionnaires were divided into two groups depending on the presence of tobacco smoke exposure. To asses the factor's relevance the odds ratio (OR) and its 95% confidence interval (CI) were used. The prevalence of smoking in families was associated with the age of the father up to 30 years (16.13 [95% CI 11.54–22.09]%; OR 2.73 [1.42–5.25]), mother’s and father’s low education lever (OR 2.73 [1.42–5.25] and 2.70 [1.64–4.44]), as well as with the residence of the family in the city (OR 4.30). The prevalence of smoking exposure was not associated with the income level or number of household members. The prevalence of smoking in women before pregnancy was more than 20%, and during pregnancy – 10%. After delivery women smoked in 23.91 (95% CI 20.06-28.25)% of cases. Proportion of families where smoked someone other than the mother reached 42.75 (95% CI 38.08–47.56)%. Other family members smoking negatively affected mothers’ tobacco consumption, both before and after childbirth. After pregnancy, women used both smoked tobacco and noncombustible forms of nicotine (51.52 vs 48.48%) with the same frequency. Other family members consumed smoking tobacco more often than e-cigarettes. All smokers who used electronic nicotine delivery devices more likely smoked at home (OR 5.33 [95% CI 0.53–54.04]).","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"18 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87109391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical signs of the quality level of fixed dentures in the process of use and rationale for feasibility of their replacement","authors":"B. Malanyak, A. Kordiyak","doi":"10.26641/2307-0404.2023.2.283359","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283359","url":null,"abstract":"The growing requirements for the quality of dental care necessitates expert evaluation of dental prostheses. Therefore, on the way to improve the structure and process of providing dental care, it is important to analyze the primary data of its results in quantitative and qualitative terms. The purpose of this work is to clarify the content and results of consulting care by analyzing clinically important indicators of the quality of fixed dentures that determine their applicability for further use. Among the 410 patients aged 35-81 examined for damage to abutment teeth and periodontal tissues, unsatisfactory condition of crowns and bridges, the 1st subgroup included 76 (18.5%) persons who sought counseling on their own initiative and the 2nd subgroup – 334 (81.5%) persons with referrals from other medical institutions. Quality indicators of 759 artificial crowns and 803 bridges were determined (K08.5 – unsatisfactory restoration of teeth) in the early (up to 24 months) and remote (more than 24 months of use) periods of observation using a modified index of clinical and technological quality. In patients of both groups in the early observation period 67 crowns and 101 bridges (all signs – 253), and in the remote period – 692 crowns and 702 bridges (3804 signs) of low quality were revealed. Quality index of these structures in the early and remote periods of observation was 0,71 versus 0,36 (p<0.05) and 0.64 versus 0.37 respectively (p<0.05). In 71 (93.4%) patients of the 1st group grounds for replacement of 292 out of 327 (89.3%), and in 238 (71.3%) patients of the 2nd group – 827 (67.0%) out of 1235 fixed partial dentures were found. Thus, expert assessment of the quality of dental care is an integral part of ensuring the predicted results of prosthetic treatment. The proposed method of assessing the clinical and technological quality of fixed dentures makes it possible to determine their suitability or unsuitability for further use.","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"50 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84855187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of TAP block and epidural analgesia for postoperative analgesia after robotic-assisted radical prostatectomy","authors":"O. Volkov, Lutsenko V.V., M.O. Plis, M.V. Pavlenko, Krishtafor D.A.","doi":"10.26641/2307-0404.2023.2.283258","DOIUrl":"https://doi.org/10.26641/2307-0404.2023.2.283258","url":null,"abstract":"Pain remains an important problem after radical prostatectomy, leading to discomfort and sometimes prolonged hospital stays. Despite the fact that laparoscopic procedures are less invasive surgical interventions, they can still be challenging in terms of postoperative pain, as both somatic and visceral pain pathways are involved. To alleviate pain and optimize improved recovery after laparoscopic prostatectomy, regional anesthesia techniques have been used to avoid or reduce the need for opioids. The aim of our study was to investigate the postoperative recovery of patients after laparoscopic robotic-assisted radical prostatectomy, depending on the method of postoperative analgesia and in the context of the peculiarities of anesthesia in robotic surgery. To achieve this goal, the “Medical Plaza” Medical Center examined 49 patients who underwent radical prostatectomy using a robotic system. Patients were divided into 2 groups. Group 1 (n=25) – combined intraoperative anesthesia with epidural analgesia with 0.125% bupivacaine. Patients in group 2 (n=24) underwent TAP-block with 15 ml of 0.25% bupivacaine immediately after the last suture was placed on the skin both sides of the abdomen. Patients in the groups did not differ in age, height, body weight and physiological status (р&gt;0.05) according to the American Society of Anesthesiologists (ASA) scale. When analyzing the statistical data it was found that the volume of the prostate did not differ in the study groups, as well as the duration of the operation and the amount of blood loss (р&gt;0.05). Blood pressure and heart rate fluctuations were similar between the groups. The amount of muscle relaxants used had no statistical difference in the study groups (р&gt;0.05). The amount of opiates used during anesthesia did not differ (р&gt;0.05). Mobilization of patients in both groups occurred in 8 hours without statistical difference (p=0.094). A direct medium strength significant correlation was found between the method of analgesia and weakness in one of the lower limbs at the time of mobilization (r=0.69; p=0.039), a direct medium strength significant correlation was found between the size of the prostate and the time to tracheal extubation (r=0.39; p=0.041). So, the level of intraoperative blood loss did not depend on the variants of perioperative analgesia. Haemodynamics and heart rate did not decrease with the addition of intraoperative epidural analgesia. Intraoperative initiation of epidural analgesia with a low concentration of local anesthetic does not affect the rate of postoperative mobilization. Pain after robotic radical prostatectomy is moderate, but requires multimodal treatment for faster mobilization of the patient, adaptation to the existing urinary catheter. Both epidural analgesia and TAP block have shown sufficient safety profile and efficacy in postoperative pain management. After radical prostatectomy, the TAP-block is an effective method of analgesia, while not interfering with the time","PeriodicalId":41059,"journal":{"name":"Medical Perspectives-Medicni Perspektivi","volume":"17 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87252748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}