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The paper evaluates the effectiveness of the use of therapeutic laser exposure (photobiomodulation therapy – PBMT) to minimize acute pain in the early postoperative period in patients after septoplasty. The study included two groups of patients. Patients of the first group (31 patients) underwent septoplasty with standard management in the postoperative period. Patients of the second group (31 patients) also underwent septoplasty, and then added PBMT to the standard measures of the postoperative period at 3, 6 and 24 h after septoplasty (λ = 0.890 μm, P = 10 W, 2 min) and then intranasally 48 h after septoplasty (λ = 0.630 μm, P = 8 W, 2 min). In patients of both groups, heart rate variability and pain were assessed using a visual analog scale within 48 hours after septoplasty. In patients of the second group, after the use of PBMT, the indicators of heart rate variability had a significantly lower total power, compared with patients of the first group. So, after PBMT, the ultra-low-frequency component of the spectral analysis of heart rate variability in the first group was 18580 ± 2067 ms2, which is significantly higher than in the second group (8086 ± 3003 ms2) (p <0.001). The low-frequency component of heart rate variability was also significantly higher in the first group (1871 ± 405 ms2) compared to the second (1095 ± 190 ms2) (p <0.005), which indicates an increase in the tension of the sympathetic part of the autonomic nervous system in the group without the use of PBMT. In the first 3 hours after surgery, the severity of pain between the groups did not differ significantly (p = 0.07). In the period from 6 to 24 hours after surgery, patients who did not undergo PBMT experienced significantly higher pain than patients with PBMT (p <0.001). Thus, in our study, the group of patients with PBMT showed better results in pain and heart rate variability compared to the classical rehabilitation of patients after septoplasty.

The aim of the study was to evaluate acute pain syndrome in patients after septoplasty and various strategies of general anesthesia. Materials and Methods. All patients received local infiltration anesthesia with 2 % procaine solution. In group 1 (n=105), a 2 % solution of promedol and 60 mg of ketorolac were used as evening premedication; in group 2 (n=108), fentanyl, propofol, cisatracuria besylate, tranexamic acid, atropine and metoclopramide were used; in group 3 (n=78), atracuria besylate, sodium thiopental, nitrous oxide and halothane were used. In groups 2 and 3, 100 mg of ketoprofen was injected intramuscularly in the evening of the postsurgical day. Anterior tamponade was carried out with foam tampons. The tamponade was removed on the 2nd day in the groups 1 and 2, and in group 3 it was removed one day after the surgery. Pain syndrome was assessed in 1, 3, and 6 hours, 1 and 2 days after surgery using a visual analogue scale (VAS), a verbal “lightning” scale (VLS), and a numeric rating scale (NRS). Pain was also assessed 1 hour after tamponade removal. Results. At all stages of the examination (except Day 2), the pain syndrome was less pronounced in group 2. A day after surgery, the patients of group 3 had more severe pain if compared with those of other groups. Conclusion. During septoplasty, the least painful reaction is provoked by the general anesthesia scheme as used in group 3: fentanyl, propofol, cisatracuria besylate, tranexamic acid, atropine and metoclopramide. In case of nasal tamponade after septoplasty, the tampons should be removed on the 2nd day after surgery. Key words: septoplasty, anesthesia, analogue scales, pain. Цель исследования заключалась в оценке острого болевого синдрома у пациентов после септопластики при применении различных тактик общей анестезии. Материалы и методы. Ко всем пациентам применяли местную инфильтрационную анестезию 2 % раствором прокаина. В 1-й группе (105 чел.) использовали премедикацию 2 % раствором промедола и 60 мг кеторолака вечером, во 2-й группе (108 чел.) – фентанил, пропофол, цисатракурия безилат, транексамовую кислоту, атропин и метоклопрамид, в 3-й группе (78 чел.) – атракурия безилат, тиопентал натрия, закись азота и галотан. Во 2-й и 3-й группах вечером в день операции внутримышечно вводили 100 мг кетопрофена. Переднюю тампонаду осуществляли поролоновыми тампонами в резиновой перчатке. В 1-й и 2-й группах тампонаду удаляли на 2-й день, а в 3-й группе – через сутки после операции. Болевой синдром оценивали через 1, 3 и 6 ч, 1 и 2 сут после операции с помощью визуально-аналоговой шкалы, вербальной шкалы-«молнии», цифровой рейтинговой шкалы. После удаления тампонов боль оценивали через 1 ч. Результаты. На всех этапах обследования, кроме 2-го дня, болевой синдром был менее выражен во 2-й группе. Через сутки у пациентов 3-й группы боль была выше, чем в остальных. Выводы. При проведении септопластики наименьшую болевую реакцию провоцирует схема общей анестезии, примененная в 3-й группе: фентанил, пропофол, цисатракурия безилат, транексамовая кислота, атропин и метоклопрамид. В условиях тампонады носа после септопластики тампоны необходимо удалять на 2-й день после операции. Ключевые слова: септопластика, анестезия, аналоговые шкалы, боль.