Study of the intensity of postoperative pain after mine-explosive injury: a pilot study of different analgesics

Abstract

Background. Mine-explosive injuries, often associated with traumatic and complex circumstances, pose unique challenges in the field of surgical interventions (SI) and subsequent pain management. That is why the main goal of this study was to determine the safety and effectiveness of a single dose of dinalbuphine sebacate 150 mg/2 ml as a component of multimodal analgesia applied intramuscularly before reconstructive surgeries due to mine-explosive lesions. Materials and methods. A prospective, open, non-randomized clinical study was carried out with the participation of 15 patients with mine-explosive injuries, who were treated using dinalbuphine sebacate 150 mg/2 ml as a component of multimodal anesthesia for postoperative pain. All patients received a single dose of dinalbuphine sebacate 150 mg/2 ml intramuscularly using the Z-technique in the gluteal area 12–24 hours before surgery. The Visual Analogue Scale (VAS) with a range from 0 to 10 points (0 = no pain, 10 = the worst imaginable pain) was used as a tool for assessing the severity of the pain syndrome. The StataCorp 2023 program was used for statistical analysis. Stata Statistical Software: Release 18. College Station, TX: StataCorp LLC. Simple linear regression analysis was used to study the relationship between Injury Severity Score (ISS) and VAS. Results. No statistically significant relationship between ISS and VAS was found. The study showed that 6 h after SI, the level of pain significantly decreased in comparison with that 6–8 hours after the use of the drug and was not statistically significantly different from the indicators of the following four days: VAS 6 hours after SI vs. 12 hours after SI — p = 0.2500, VAS 6 hours after SI vs. 24 hours after SI — p = 1.0000, VAS 6 hours after SI vs. 48 hours after SI — p= 0.4531, VAS 6 hours after SI vs. 96 hours after SI — p= 0.2188. At the same time, a statistically significant difference was found between VAS 6 hours after SI vs. 120 hours after SI — p= 0.0010. Conclusions. The efficacy and favorable to-lerability of dinalbuphine sebacate as a component of multimodal analgesia in the setting of postoperative analgesia in patients after reconstructive surgical interventions caused by mine-explosive injuries was demonstrated.

Keywords

• multimodal analgesia
• chronic pain
• postoperative pain
• dinalbuphine sebacate
• mine-explosive injury