Browsing by Author "Likić, Ivana (23497909500)"

Chronic postoperative pain (CPOP) is a serious health issue that affects millions of patients every year. The incidence of CPOP is the highest after amputations, inguinal hernioplasty, thoracotomies, cardiac surgery and breast surgery. In addition to surgical factors, the other risk factors are: female gender, younger age, preoperative pain, psychological state and acute postoperative pain. The most common expression of CPOP is neuropathic pain after surgical trauma. The treatment of chronic postoperative neuropathic pain (CPNP) is difficult. Various methods have been recommended for its prevention, the most important being techniques that avoid nerve damage and adequate perioperative analgesia. The goal of this review was to discuss data from published studies examining the incidence, risk factors and mechanisms of CPOP, with a focus on surgery, the unique opportunity to implement pharmacological strategies for prevention of CPNP and current pharmacotherapy approaches for treatment of CPNP. Commonly used drugs to prevent and treat CPNP in the current clinical setting are: opioids, α2-adrener-gic agonists, cyclooxygenase antagonists, gabapentin, pregabalin, steroids, N-methyl-D-aspartate receptor antagonists and local anesthetics. © 2023, Dr. Mladen Stojanovic University Hospital. All rights reserved.

Background/Aim. Concerning the growth of ovarian carcinoma incidence and bad prognosis for malignant forms, early and precise diagnostics is gaining in importance as a condition for precise and appropriate therapy for ovarian tumor masses. The aim of this study was to analyze pre- and postoperative findings of patients with adnexal masses in order to identify factors which could predict the nature and stage of the tumor prior to surgery. Methods. All patients with adnexal masses who were treated in a 6-month period in the Institute of Obstetrics and Gynecology, Clinical Center of Serbia, (IOG, CCS), Belgrade, had their epidemiologic and gynecologic anamnesis and standard laboratory analyses taken prior to surgery. Also, clinical and ultrasonographic check up of pelvic organs was performed, as well as calculation of body mass index (BMI) and risk of malignancy index (RMI). After surgery we analyzed histopathological (HP) findings of tumors as a mean of final diagnosis and staging. For statistical analysis, we used SPSS 15 program. Results. Throughout a 6-month period, we examined 81 patients with adnexal masses treated in the IOG CCS. HP findings showed that there were significantly more benign (n = 51) than malignant (n = 30) tumors in all the patients (χ2 = 5.512). The patients with malignant HP findings were significantly older than those with benign adnexal masses (t = 3.362; p = 0.001). Significantly more patients with malignant HP findings were in menopause (p = 0.034). BMI values were highly significantly higher in the patients with malignant adnexal tumors (t = 3.421; p = 0.001). There was a statistically significant positive correlation between HP categories (benign, malignant) and RMI categories (low, intermediate and high risk) of all the patients (high risk, more malignant HP) (Roxy = 0.428; df = 78; p = 0.000). Conclusion. Patients in menopause, especially older ones, with high BMI and RMI should immediately be referred to a tertiary level institution, where appropriate surgery could be performed.