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Objective: Evaluation of the effectiveness of a multimodal scheme of postoperative analgesia based on a fixed combination of orphenadrine and diclofenac against the background of patient-controlled analgesia with morphine in the early postoperative period in cardiac surgery patients., Material and Methods: A prospective, randomized, comparative study evaluated two analgesic regimens. In 20 patients (group 1), «Neodolpasse» (a fixed combination of 30 mg Orphenadrine and 75 mg Diclofenac) was administered immediately after trachea extubation. The second injection was performed at VAS>50 mm not earlier than 12 hours after the first one. Patient-controlled analgesia (PCA) with morphine was started 2 hours after extubation, 20 patients of group 2 who were used PCA with Morphine as monotherapy. The intensity of pain taking into account the motor activity of patients was assessed a 100 mm visual-analog scale (VAS), as an additional objective criterion for the effectiveness of analgesia, the method of incentive spirometry was used., Results: A decrease in the severity of pain according to VAS from an average of 41 to 19 mm ( p =0.036) was achieved already by the 1st hour from the start of Neodolpasse infusion, and in 80% of patients this effect persisted for 24 hours. 2 patients (10%) needed the administration of the 2nd dose after 12 hours. The infusion of Morphine was started 2 hours after extubation, a significant decrease in pain intensity was noted only at 4th hour, a significant decrease in pain intensity was noted only by 4 hours, and significant differences in the severity of pain in the comparison groups persisted at almost all stages of the study. The analgesic effect of the combination of orphenadrine and diclofenac had a positive effect on the function of respiration system with an increase in MILC by 1.5 times from the beginning of the study. In group 2, the observed adverse effects were associated with the use of Morphine and depended on its dose. No adverse effects of Neodolpasse were noted. The total 24 hour consumption of Morphine at PCA averaged 22.6 mg, and in the Neodolpasse group - 9.35 mg ( p <0.001)., Conclusion: There were demonstrated high analgesic efficacy, safety and significant opioid-sparing effect of a fixed combination of orphenadrine and diclofenac in the early postoperative period of cardiac surgery patients.

Objective: Evaluation of the safety and effectiveness of the use of a fixed combination of orphenadrine and diclofenac for analgesia in the early postoperative period of cardiac surgery patients., Material and Methods: There were two analgesia regimens evaluated in a retrospective comparative study. In 23 patients (group 1), Neodolpasse (a fixed combination of 30 mg orphenadrine and 75 mg diclofenac) was administered immediately after trachea extubation. When the severity of pain in VAS increased to more than 50 mm, so 20 mg trimeperidine was administered. In group 2 of 20 patients analgesia in group 2 was performed with patient-controlled analgesia (PCA) with Promedol (trimeperidine) as monotherapy. The intensity of pain was assessed a 100 mm visual-analog scale (VAS) and 5-channel verbal scale (VS) for assessment the severity of the pain syndrome during the patient's moving activity., Results: A decrease in the severity of the pain syndrome according to VAS from 68.31 to 21.96 mm ( p <0.001) was achieved by the first hour after the start of the infusion of Neodolpasse persisted for 24 hours of 65% patients. 4 patients (35%) needed the administration of the 2nd dose after 12 hours. The infusion of trimeperidine was started 2 hours after extubation, a significant decrease in pain intensity was noted only at 6th hour, and further differences in the severity of pain in the comparative groups did not significantly differ. In group 2, the observed adverse effects were associated with the use of trimeperidine and depended on its dose. No adverse effects of Neodolpasse were noted. In the Neodolpasse group no adverse effects of the treatment was noted. The total 24 hour consumption of trimeperidine at PCA averaged 72.3 mg, and in the Neodolpasse group - 6.96 mg ( p =0.00042)., Conclusion: There were demonstrated safety, high analgesic efficacy and significant opioid-sparing effect of a fixed combination of Orphenadrine and Diclofenac in the early postoperative period of cardiac surgery patients within the framework of the inclusion and exclusion criteria accepted in the study.