Efficiency evaluation of acute pain treatment in the early postoperative period in urological patients

Objective. To evaluate efficency of applying adjuvant multimodal analgesia (MMA) in urological patients in the early postoperative period.

Materials and methods. The study included 80 patients with planned surgical interventions of transvesical or transurethral adenomectomy, transurethral resection of the bladder formation, who underwent surgical treatment at the Gomel City Clinical Hospital No. 2. The average age of patients was 59.8±10.6 years old for males (n=74) and the average age of 6 female patients was 57.4±7.2. The study period included 2023-2025. The study group included 40 people. The surgical intervention was performed on a planned basis in urological patients in remission without concomitant pathology or with somatic concomitant pathology in the compensation stage without disruption of the internal organs, and without signs of acute or chronic infection. The study group included 40 individuals. The patients of this group received spinal anesthesia and intravenous ketamine bolus administration prior to the surgical incision following MMA nonsteroidal anti-inflammatory drugs (NAID). The comparison group included 40 patients. This group received spinal anesthesia without additional ketamine administration on an incision, and without MMA in postoperative period. The patients were matched for gender, weight and height, nosological, and functional characteristics.

Results. In this prospective cohort study, it was possible to achieve a 25% reduction in the daily dose of opioid analgesics (promedol) with the use of ketamine adjuvant at p<0.05, which reduces pain sensitivity according to the visual analogue scale (VAS) by 43% after 12 hours after operative treatment, and achieve a complete analgesia after 24 hours against the background of spinal anesthesia in comparison with the group where ketamine was not used.

Conclusion. Administration of the preventive analgesia with ketamine in the perioperative period with selected drug dosages during the day after surgery is an effective method of analgesia in elderly patients with urological problems.

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