ABSTRACT
Aim: The aim of the study was to determine the impact of cranioskeletal trauma (CST) on the development of endogenous intoxication syndrome in rats of different ages.
Materials and Methods: The experiments involved 147 white male Wistar rats of different age groups. The first experimental group included sexual immature rats aged 100-120 days. The second group includes sexually mature rats aged 6-8 months. The third group included old rats aged 19-23 months. In all experimental groups, CST was modelled under thiopentalonatrium anaesthesia. The control rats were only injected with thiopentalonatrium anaesthesia. The animals were withdrawn from the experiments under anaesthesia after 1, 3, 7, 14, 21 and 28 days by total bleeding from the heart. In blood serum, the content of fractions of molecules of middle mass was determined at a wavelength of 254 and 280 nm (MMM254, MMM280).
Results: As a result application of CST in rats of different age groups, an increase in the serum content of MMM254 and MMM280 was observed with a maximum after 14 days and a subsequent decrease by 28 days. At all times of the experiment, the indicators were statistically significantly higher compared to the control groups. The degree of growth of the MMM254 fraction after 1, 7 and 14 days was statistically significantly higher in sexual immature rats, and after 21 and 28 days – in old rats. In old rats after 21 and 28 days of the post-traumatic period, the content and degree of growth of the MMM280 fraction in the blood serum were also significantly higher.
Conclusions: Modelling of CST in rats of different age groups is accompanied by the development of endogenous intoxication syndrome, which is manifested by the accumulation of MMM254 and MMM280 fractions in the blood serum with a maximum after 14 days of the experiment. The content of the serum fraction of MMM254 in sexual immature rats in the dynamics of experimental CST exceeds other age groups after 1, 7 and 14 days, in old rats the content of the studied MMM fractions is significantly higher after 21-28 days.
KEY WORDS: traumatic brain injury, skeletal injury, endogenous intoxication of the kidney, age, molecular of middle mass 
 

Introduction. Previous researches and the bitter experience of other countries affected by armed conflicts show that at least one in five people will have negative consequences for mental health, and one in ten will experience these consequences at the level of moderate severity or severe illness. In recent decades, much attention has been paid to mental health problems around the world, primarily due to their high prevalence and medico-social consequences, which leads to an increase in demand for psychotropic drugs. Therefore, it is advisable to conduct a marketing research of psychotropic drugs, the results of which will make it possible to establish trends in the development of the market of the investigated group of drugs and assess the mental health of young people in wartime.

Background: Surgical intervention is associated with psychological and physical stress for the patient. The severity of surgical stress is also influenced by anesthetics, analgesics, and the choice of anesthesia method. Heart rate variability (HRV) is a universal reaction of the entire body to any impact.

Methods: 92 patients aged 67.47±14.39 years (23% women) who underwent surgical treatment of hernias of the anterior abdominal wall took part in the study. Patients were divided into 3 groups according to the method of anesthesia: 1st group (n= 32) operated under general multicomponent anesthesia, 2nd group (n= 30) with neuraxial (spinal or epidural) anesthesia, 3rd group (n= 30)–regional blockades (the rectus abdominis sheath and transverse abdominal plane). A multidisciplinary decision was made on the specifics of planned surgical intervention and anesthetic support. The 3rd group included the majority of …

UDC 616.12-008.46:616.127-005.8:616-005]-07-08

Cardiogenic shock (CS) is a clinical syndrome resul琀椀ng from a sharp decrease in cardiac output, which leads to hypoperfusion of vital organs and 琀椀ssues. Despite the achievements of pharmacological therapy, mortality in CS remains high. In this regard, the role of temporary mechanical circulatory support (TMCS) methods is increasing, which allows for stabilising hemodynamics, ensuring adequate organ perfusion, and reducing the load on the myocardium. Such devices can serve as a bridge to restoring heart func琀椀on, provide long-term mechanical support, or facilitate transplanta琀椀on. Over the past decade, signi昀椀cant progress has been noted in the development of TMCS technologies, among which intraaor琀椀c balloon counterpulsa琀椀on (IABP), microaxial pump systems (Impella), transseptal ventricular assist devices (TandemHeart) and extracorporeal membrane oxygena琀椀on (ECMO) are the most widely used. The purpose of this study is to examine various op琀椀ons for modern methods of temporary mechanical circulatory
support, to compare their availability, advantages, and disadvantages, as documented in modern literature, to op琀椀mise the intensive care of pa琀椀ents with acute heart failure. Biblioseman琀椀c, compara琀椀ve and systema琀椀c analysis methods were used. The results of this study are based on
data from the analysis of modern literature, as well as the results of randomised trials and meta-analyses devoted to the study of modern methods of temporary mechanical circulatory support. The use of MCS devices in pa琀椀ents with progressive heart failure unresponsive to conven琀椀onal intensive care management provides hemodynamic support and stabiliza琀椀on and increases pa琀椀ent survival. Rather than viewing these devices as compe琀椀ng technologies, it is essen琀椀al to understand each device individually to leverage its unique proper琀椀es in various clinical situa琀椀ons. Early use of MCS devices in CS is associated with be琀琀er outcomes because they mi琀椀gate the adverse e昀昀ects of systemic hypoperfusion on target organs and reduce the need for inotropes/vasopressors, thereby minimising myocardial oxygen consump琀椀on and improving microcircula琀椀on.
Key words: cardiogenic shock, temporary mechanical circulatory support, intra-aor琀椀c balloon counterpulsa琀椀on, Impella, TandemHeart, extracorporeal membrane oxygena琀椀on

UDC 616-001-005.6-039.71

Abstract. Background. Fascial plane blocks can provide effective analgesia for abdominal surgeries. The purpose of our study was to assess whether adding erector spinae plane (ESP) block preoperatively could reduce pain after abdominal hysterectomy, compared with no regional analgesia. Materials and methods. We conducted aprospective cohort observational study that included 50 patients aged 40–55 years with complicated symptomatic
fibroids. They were divided into 2 groups. Both of them underwent general anesthesia, but the group II additionally received ESP block bilaterally. Stages of the study: intraoperative stage (h0), 30 minutes (m30), 6 (h6), 12 (h12), 24 (h24), 48 (h48), 72 hours (h72) after the surgery. We analyzed the pain level, intraoperative need for fentanyl, the daily requirement of morphine, heart rate and mean arterial pressure. Results. It was found that the level of pain according to visual analog scale in the group I reached its maximum values at the stages m30 and h6 and was 6.5 [3.0; 8.5] and 5.5 [3.0; 7.0] points, while in the II group — 4.0 [3.0; 8.5] and 3.0 [2.0; 8.0] points, respectively (p < 0.05). The daily requirement of morphine at the h24 stage was 7.5 [2.5; 7.0] mg/day
in the group I, and 5.0 [2.5; 10.0] mg/day in the group II (p < 0.05). There were differences in heart rate between the groups I and II at m30, h6 and h24 stage of study — the values were higher in the group I (p > 0.05).
Conclusions. Adding ESP block was associated with a lower need for fentanyl during surgery, pain level, and need for morphine after the surgery.
Keywords: ERAS recommendations; hysterectomy; regional anesthesia; ESP block; multimodal analgesia