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After reading this article, the reader will be familiar with the general classes of opioid agonists and partial agonists, the basics of the pharmacokinetics and pharmacodynamics of opioids, the risks of opioid therapy and the requirements for the safe and effective use of opioids in acute and chronic pain. The use of opioids during surgical procedures or anesthesia is not discussed. Also, there is no discussion about various available opioid antagonists that are used to treat overdose and the various disorders associated with their use (including naloxone and naltrexone). Opioids are available, the most powerful and effective analgesics, and have become acceptable drugs for the treatment of acute and cancerous pain. However, there is concern about their use in case of chronic pain, if there is no cancer, because they are long-range ineffective but best suited for stopping this pain. Opioid prescription must be monitored for better use. Chronic pain creates discomfort for these patients, reducing their productivity and efficiency, which, in turn, can lead to economic problems in the country. The choice of Nalbuphine is due to the following reasons: the opioid, which is comparable to morphine by its analgesic potential, but has a better safety profile for nausea, vomiting and respiratory depression; not subject to strict quantitative accounting (extract on prescription form 1); the choice of opioid analgesics is significantly limited in Ukraine.

The article presents the study of the use of parenteral forms of drugs Infulgan and Nalbuphine on the base of the Regional Mammological Center and the Department of Anesthesiology N 1 of Clinical Oncology Dispensary (Dnipro). We have generalized the experience of using these agents as part of multimodal perioperative analgesia in 15 patients who underwent a vacuum aspiration biopsy of the mammary gland using the “Mammotome HH” device. We assessed the intensity of pain in the postoperative period and the need for additional anesthesia. The results of the study showed that the pre-emptive multimodal analgesia with the use of par cetamol in the form of an infusion of Nalbuphine was effective and safe for perioperative analgesia in outpatient minimally invasive diagnostic and therapeutic operations on breast tissue. Such anesthesia made it possible to reduce the doses of anaesthetics used in the postoperative period, facilitating the return of patients to a full life after breast vacuum aspiration biopsy. Our experience may be recommended for relief of the pain syndrome after minimally invasive surgery interventions.

In medicine narcotic analgesics have long been used for therapeutic purposes, but their influence on the organs of the immune system is insufficiently studied. Aim of the work was the investigation of submicroscopic changes in the structural components of the thymus of white male rats in the dynamics of six weeks exposure of the nalbuphine to the body and one week after its abolition. Materials and methods. The study was conducted on 52 white male rats of reproductive age with an initial body weight of 140–150 g. The drug "Nalbuphine" was injected intramuscularly 1 time per day at 10–11 o’clock during 42 days, increasing the dose every 7 days. Experimental animals are divided into 8 groups: the first group – intact animals; opioid nalbuphine was daily injected intramuscularly at a dose of 8 mg/kg in the second group within 1 week; in the third group twithin 2 weeks nalbuphine dose increased to 15 mg/kg; in the fourth group within 3 weeks nalbuphine dose increased to 20 mg/kg; in the fifth group within 4 weeks nalbuphine dose increased to 25 mg/kg; in the sixth group within 5 weeks nalbuphine dose increased to 30 mg/kg; in the seventh group within 6 weeks nalbuphine dose increased to 35 mg/kg; in the eighth group material was taken one week after discontinuation of therapy. The material was collected in accordance with generally accepted rules. The slices were made on UMTP–6M ultramicrotome using diamond knife (DIATOM) and double-contrasted according to Reynolds and with uranyl acetate. The thymus sections were investigated using an electronic TEM–100 transmissive microscope. The photo documentation of studied material was carried out using SONY–H9 digital camera. Results. After one week of experiment, the intercellular space is expanded. Two weeks later, the contours of thymocyte nuclei are uneven, blurred. Three to four weeks there are destructive degenerative changes of thymocytes and epithelial reticular cells. Five to six weeks later, part of thymocytes and epithelial reticular cells have picnotic osmiofilic nuclei, an increase in the number of destructively altered thymocytes, epithelial reticular cells and macrophages with picnotial nuclei and in the state of apoptosis. One week after the discontinuation of nalbuphine, there are numerous destructively altered thymocytes and epithelial reticular cells and cells in the state of apoptosis, the nuclear membrane and plasmalemma have been damaged in some places. Conclusions. With a short-term effect of nalbuphine on the body for 2 weeks, there are no significant structural changes in the thymus. Under the action of nalbuphine for 3-4 weeks there are destructive-degenerative changes of the structural components of the thymus. With prolonged action of nalbuphine within 5-6 weeks, deep destructive degenerative changes occur, which are not restored even a week after discontinuation of the drug.

Aim. The objective of this study was to establish peculiarities of the channels of blood supply of the telencephalon radiate crown of the rat in norm and in the dynamics in 6 weeks long injection of nalbuphine. Methods and results. The research work was carried out on 24 mature white male rats aged 3.0 – 4.5 months weighing 160-270 g. The method applied in the study was injection of bloodstream along with morphometric and statistical methods. Morphological and morphometric analysis of angioarchitecture of telencephalon radiate crown allowed to evaluate the degree of its vascularization in case of a long-term effect of nalbuphine. Conclusion. Results showed that there is a clearly observed connection between the depth of structural transformations of the parts of hemomicrocirculatory bloodstream of the rat’s radiate crown under the influence of opioid and the morphometric indices. The obtained results can serve as the morphologic basis for further scientific research in neurology.

In recent decades the issue of drug addiction has appeared to be not only a social, but medical problem. Aim. To establish peculiarities of the microstructure of the rat’s cerebellar cortex in the norm and to investigate changes in the structural organization of cerebellar cortex determined by injection of the opioid, particularly nalbuphine, in the experiment. Methods and results. These investigations were carried out on 26 mature white male rats aged 3.0–4.5 months and body weight 160–270 g. The research material was presented by histological specimens of the rats’ cerebellar cortex. Sections of the cerebellar cortex for histological examination were stained with hematoxylin and eosin. The first signs of disorders in the structure of the rat’s cerebellar cortex have been detected already after 2 weeks of the experimental injection of nalbuphine. Destructive changes in cerebellar cortex cells and in the haemomicrocirculatory bloodstream increased gradually during 6 weeks of the experiment. Conclusion. Thus, nalbuphine injection during 6 weeks of the experiment leads to disorganization of microstructure and angioarchitecture of cerebellar cortex.