Influence of Various Postoperative Analgesia Regimens on the Level of Markers of the Systemic Inflammatory Response and System of Regulating the Aggregate State of Blood in Geriatric Patients with Polytrauma

The aim of the study was to compare the effect of various postoperative analgesia regimens on the level of the markers of the systemic inflammatory response and the system parameters of regulating the blood aggregate state in geriatric patients with polytrauma. Materials and methods. All patients were divided into 3 groups. In group 1, they received morphine 10 mg, in the 2nd group – nalbuphine 10 mg, in the 3rd group – combination of the central inhibitor cyclooxygenase infulgan with rheumoxicam. The study was conducted on the 1st, 3rd, 5th and 7th days after surgery. The concentration of mediators of systemic inflammatory response and indicators of the system of regulating the blood aggregate state was studied. Results and discussion. In group 3, with the cyclooxygenase inhibitor therapy, the interleukins level was significantly lower than in the groups of patients receiving opioids (p<0.02). On the 1st day after the operation, the endothelin - 1 level significantly decreased in patients of group 3, whereas there were no significant changes in its concentration (when group 3 was compared with groups 1 and 2 p<0.015) in groups 1 and 2. Only on the 5th day the tendency for hypercoagulability in groups 1 and 2 began to decrease. It was fixed in group 2 to a greater extent, so that there were no statistically significant differences observed between groups 2 and 3, whereas between groups 1 and 3 they were stored. We also checked the level of markers of the systemic inflammatory response in the postoperative period in geriatric patients with polytrauma in the application of the studied anesthetic regimens. Concentration of interleukins on the 1st day after operation was naturally elevated in patients of the 1st and the 2nd groups without any significant differences between them. In group 3, with the cyclooxygenase inhibitor therapy, IL levels were already significantly lower than in opiate groups (p<0.02). Conclusions. The revealed correlation dependences illustrate the etiological significance of the severity of the inflammatory response reactions in the development of the pain syndrome and confirm the expediency of suppressing these reactions during its treatment.