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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">asurgery</journal-id><journal-title-group><journal-title xml:lang="ru">Амбулаторная хирургия</journal-title><trans-title-group xml:lang="en"><trans-title>Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2712-8741</issn><issn pub-type="epub">2782-2591</issn><publisher><publisher-name>ООО «ГРУППА РЕМЕДИУМ»</publisher-name></publisher></journal-meta><article-meta><article-id custom-type="elpub" pub-id-type="custom">asurgery-76</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>АМБУЛАТОРНАЯ АНЕСТЕЗИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>OUTPATIENT ANESTHESIA</subject></subj-group></article-categories><title-group><article-title>Кеторолак в схеме мультимодального обезболивания</article-title><trans-title-group xml:lang="en"><trans-title>Ketorolac in a multimodal pain management scheme</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ванданов</surname><given-names>Б. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Vandanov</surname><given-names>B. K.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шихметов</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Shikhmetov</surname><given-names>A. N.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лебедев</surname><given-names>Н. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Lebedev</surname><given-names>N. N.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Отраслевой клинико-диагностический центр ПАО «Газпром»<country>Россия</country></aff><aff xml:lang="en">Branch Clinical Diagnostic Center of PJSC Gazprom<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2017</year></pub-date><pub-date pub-type="epub"><day>20</day><month>06</month><year>2017</year></pub-date><volume>0</volume><issue>1-2</issue><fpage>65</fpage><lpage>69</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Ванданов Б.К., Шихметов А.Н., Лебедев Н.Н., 2017</copyright-statement><copyright-year>2017</copyright-year><copyright-holder xml:lang="ru">Ванданов Б.К., Шихметов А.Н., Лебедев Н.Н.</copyright-holder><copyright-holder xml:lang="en">Vandanov B.K., Shikhmetov A.N., Lebedev N.N.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.a-surgeon.ru/jour/article/view/76">https://www.a-surgeon.ru/jour/article/view/76</self-uri><abstract><p>Боль, являясь мощным триггером хирургического стресс-ответа, за счет нейрогуморальных, эндокринных, иммунных, гемостатических и метаболических механизмов в значительной мере определяет результаты хирургического лечения. Наиболее часто используемым НПВП является кеторолак (кеторол), имеющий парентеральную форму введения. Улучшение качества послеоперационного обезболивания предопределило создание протокола анальгезии, в качестве базисных препаратов используются НПВП. Для лечения послеоперационного болевого синдрома в условиях ОКДЦ в настоящее время используется сочетание лекарственных препаратов с разными механизмами действия, в зависимости от вида операции, с учетом характера и тяжести основной и сопутствующей патологии у пациента. С этой целью в первую очередь назначаются НПВП, действие которых уменьшает ноцице-птивную активацию рецепторов в периферических тканях, а также применяются методы обезболивания с преимущественным подавлением передачи болевого импульса на сегментарном и супрасегментарном уровне.</p></abstract><trans-abstract xml:lang="en"><p>Pain, as a powerful trigger of stress response to surgery, largely determines the results of surgical treatment through neurohormonal, endocrine, immune, metabolic and hemostatic mechanisms. The most commonly used NSAID is ketorolac (ketorol) which is administered parenterally. Improvements in the quality of postoperative analgesia predetermined the creation of a protocol with NSAIDs as the basic medications. For the treatment of postoperative pain, the Clinical Centre currently uses a combination of drugs with different mechanisms of action depending on the type of surgery, the nature and severity of primary and associated pathology in patients. For this purpose, NSAIDs are initially administered as they reduce activation of nocicep-tors in peripheral tissues; anesthesia with preferential inhibition of transmission of pain impulse at the segmental and suprasegmental levels is also applied.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>НПВП</kwd><kwd>кеторолак</kwd><kwd>амбулаторная хирургия</kwd><kwd>мультимодальная анальгезия</kwd><kwd>NSAID</kwd><kwd>ketorolac</kwd><kwd>outpatient surgery</kwd><kwd>multimodal analgesia</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Баринов А.Н. Роль гомосинаптической стимулзависимой нейро-нальной пластичности (феномена «взвинчивания») в хронифи-кации болевых синдромов. ConsiL Medicum., 2010, 12(2): 53-60.</mixed-citation><mixed-citation xml:lang="en">Баринов А.Н. 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