Objective. To analyze the major risk factors of cardiovascular complications at all stages of surgical treatment of elderly and senile patients with colorectal cancer and concomitant cardiovascular diseases. Material and methods. We enrolled 97 patients (51 men and 46 women) over 60 years old with comorbid cardiovascular diseases between January 2018 and September 2022. All ones underwent surgery for colorectal cancer including fast track postoperative technologies. Mean age of patients was 72.8±6.8 years. Results. Complicated postoperative period depended on NYHA class of heart failure, body mass index, heart valve disease and ASA class. Complicated postoperative period significantly lengthened ICU- and hospital-stay. Conclusion. Careful postoperative cardiac monitoring of elderly patients with colorectal cancer indicates potential need for aggressive treatment of pre-existing comorbid diseases.

In the last 20 years, there has been a widespread actualization of the problem of chronic postoperative pain. At least 10—40% of operated patients suffer from chronic pain. This article highlights aspects of the current state of the problem of chronic postoperative pain, discusses risk factors and the possibility of predicting pain chronicity, as well as the need for an interdisciplinary approach in terms of prevention and treatment. For the effective prevention and treatment of chronic postoperative pain In Russia, an adaptive interdisciplinary model is proposed. This model includes a range of measures: early identification of risk factors during preoperative preparation, the use of gentle surgical techniques, personalized multimodal analgesia after surgery, and the development of individualized rehabilitation programs. Understanding the psychological aspects of pain development and actively involving the patient and their family in decision-making regarding treatment and rehabilitation are crucial.

The development of postoperative pain syndrome (POPS) and its chronification in patients who have undergone surgical interventions remains an underestimated problem in modern clinical practice. Inadequate diagnosis and prevention of acute pain chronification significantly worsen the quality of life of patients. Objective. To investigate the effectiveness of cognitive-behavioral therapy (CBT) combined with pharmacotherapy in the treatment of POPS and the prevention of its chronification. Material and methods. The study included 62 patients who underwent cardiac surgery. Patients in the main group (n=31) received standard therapy combined with CBT sessions, which included cognitive restructuring, behavioral activation, and exposure therapy. Results. After three months of treatment, pain intensity, as well as levels of anxiety, depression, and pain catastrophizing, were significantly lower in the main group compared to the control group. The rate of pain chronification was also significantly lower in the group that received CBT. Conclusion. Thus, the integration of psychotherapeutic methods in the treatment of POPS is an effective strategy that improves surgical outcomes and reduces the risk of pain chronification.

The aim of the study. To evaluate the effectiveness of classical corporal acupuncture for the treatment of acute and prevention of chronic postoperative pain. Material and methods. The study included 100 patients (65 women and 35 men), aged 23 to 75 years, who underwent cardiac surgery in the period from August 2023 to June 2024, who had postoperative pain 1 month after the operation. Randomized into the main and control groups of 50 people, all patients received drug therapy (lornoxicam 16 mg / day, 14 days, omeprazole 20 mg / day, 14 days and gabapentin at a dose of 1200—2700 mg / day for a long time), and patients of the main group additionally received acupuncture (IRT) — 3 procedures per week for 4 weeks (12 sessions). At the time of inclusion in the study and after 2 months, all patients had their pain intensity assessed using the VAS; the DN-IV questionnaire was used to identify the neuropathic nature of the pain. All patients were tested using the Hospital Anxiety and Depression Scale (HADS), the Pain Catastrophizing Scale (PCS) — at the time of inclusion in the study and after 2 months — to assess the treatment results. Statistical data processing was performed using IBM SPSS Statistics and MS Excel. Differences were considered statistically significant at p < 0.05. Results. Demographic characteristics had no reliable differences — the average age in the main group was 59.07±12.46 years, in the control group — 58.63±9.17 years, p = 0.26, the male / female ratio in the main group was 17/33, in the control group — 18/32. The pain intensity according to VAS was high and did not differ between the groups, amounting to 6.7±0.8 points in the main group and 6.9±0.9 points in the control group (p=0.15). The anxiety level was 8.5±2.3 points for the main group and 8.6±2.4 points in the control group (p>0.05). The depression level was 7.7±2.2 and 7.9±2.3 points (p>0.05) for the main and control groups, the PCS scale was 16.5±4.8 and 16.9±5.0 points in the main and control groups, respectively (p>0.05). One month after the IRT course, the pain intensity according to VAS in the main group decreased to 3.2±1.2 points and to 4.1±1.5 points in the control group (p<0.05). After two months (by the end of the third postoperative month), the pain intensity was 1.9±1.0 and 2.8±1.4 points (p<0.05) in the main and control groups, the anxiety level was 3.5±1.3 and 5.9±1.9 points (p<0.05) in the main and control groups, the depression level was 4.1±0.6 and 6.4±0.8 points (p<0.05) in the main and control groups, the average score on the PCS scale was 12.7±2.4 and 19.8±2.9 points in the main and control groups, respectively. After 2 months of observation (i.e. 3 months after surgery), only 6 (12%) respondents in the main and 18 (35%) patients in the control groups met the criteria for chronic obstructive pulmonary disease. Conclusion. The use of IRT in complex postoperative pain relief increases its effectiveness and reduces the incidence of chronic postoperative pain.