[Preventive analgesia: true of preventing the postoperative pain syndrome]

A total of 152 patients subjected to operations mainly of an orthopaedic profile were divided into 8 groups for the development of the optimal method of preventive analgesia. The best results were attained by combined use of opiate premedication, regional blocking as a component of anesthesiologic care, and parenteral diclophenak-Na before and after the operation. 31.5% of patients in this group did not need any postoperative analgesia. In the rest cases we observed the longest postoperative pain-free period, the least intensity of pain, and low need in additional analgesics during the first 24 h postoperation in comparison with the control groups (p < 0.05), in which one or several of the above components were excluded from the protocol of anesthesia. Preventive analgesia reduced the incidence of phantom pain syndrome after limb amputation in patients with the preamputation pain from 63.3 to 25.1%. The postoperative pain syndrome may be prevented if the factors determining it (preoperative pain, intraoperative nociceptive stimulation, and perioperative tissue inflammation) are eliminated simultaneously.