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SUMMARY In effective control of acute postoperative pain, it is essential to respect the principles of multimodal balanced analgesia, and to apply them within organized units for the management of acute postoperative pain (acute pain service). The aim of the study was to find out patient expectations and experience in the intensity of acute postoperative pain, and the efficiency of therapy they received. Between October 11, 2002 and December 14, 2002, 103 patients having undergone elective operative procedures under general endotracheal anesthesia were surveyed at Karlovac General Hospital. All patients were asked the preoperative group of questions on the intensity of pain they expected after surgery and on the intensity of pain at which he/she wanted to be given an analgesic. The postoperative group of questions referred to the intensity of pain 24 hours after the operative procedure and to the reason for not taking an analgesic. Results showed that prior to surgery, 33.98% of patients expected mild and 37.86% moderate postoperative pain. After the surgery, most patients felt moderate pain (33.98%). The study showed the therapy for acute postoperative pain and pain control to be still inadequate. The preconditions for successful pain control are the existence of acute pain service and implementation of the multimodal balanced analgesia concept. In this context, it is important to stress the education of patients as well as of the entire team participating in the management of pain.

The effectiveness of sedation in the ICU is routinely assessed by subjective monitoring of the patient's clinical condition or by using the monitors. The aim of our study was to review the monitoring of sedation using bispectral analysis (BIS) in medicalsurgical ICU. A retrospective analysis of patients who were treated in the ICU from 2008 to 2014 was made. The data of 104 patients were analyzed. The average values of age are 54.38 (SD ±18,93; median 58). 39 (37,5%) of the patients died. The patients were referred to the ICU from medical (37), surgical departments (23) and traumatology (44). The patients were treated in the ICU for 13.84 days (SD ±17.29; median 8). The burst suppression pattern was noticed in 31 (29.8%) patients. Delirium occurred in 3 patients after the separation from the ventilator. In heterogeneous groups of patients, in which BIS was applied, it is not possible to make certain conclusions. The cost of the method unfortunately limits its wider usage. It is necessary to wait for the results of future studies which will set clear indications for the use of BIS in certain groups of patients.

The new method of monitoring lung function ("vibration response imaging"-VRI) converts vibration energy that appears in the bronchial tree during airflow into an image. The VRI does not use energy that could have a detrimental effect on the cells and organs. The goal of our research was to verify the VRI device in the diagnosis and the localization of various lung pathologies. In our medical-surgical ICU we did a retrospective analysis of the prospective database that included 61 patients. We compare VRI with chest X-ray and CT scan in patients with intrathoracic (the presence of air and fluid in the intrapleural space, pulmonary hypoventilation, atelectasis, contusion and inflammatory lung pathology) or extrathoracic pathology that affect respiratory function. Intrathoracic pathology was observed in 32 patients and extrathoracic pathology in 29 patients. The use of the VRI device showed earlier disorder of hypoventilation compared to chest X-ray, especially after abdominal surgical procedures, intraabdominal hypertension and various lung pathology as it detected laterobasal pneumothorax earlier.In our patients VRI has been proven to be a reliable method for detecting regional distribution of ventilation and atelectasis of the lungs of individual parts regardless of pulmonary pathology. VRI is shown as a reliable method for detecting air and fluid in the intrapleural space.