According to British scientists, about 300 million operations are performed around the world annually. They cause acute postoperative pain, the management of which is crucial for improving patient outcomes and reducing healthcare costs. Local anesthetic infiltration before closing the surgical incision is a commonly used technique in the operating room. This review focuses on the use of local anesthetic infiltration, 0.25% bupivacaine, into surgical incisions to reduce postoperative pain, as confirmed by an estimate of a reduction in the use of postoperative opioids and a visual analogue scale (VAS). The presented clinical cases and the combined analgesia scheme with infiltration of a local anesthetic into the postoperative wound were used to make it possible to argue about the effectiveness of anesthesia because on the peripheral mechanism of pain. Infiltration analgesia reduced the need for opioids and the time of stay in hospitals. It was concluded that there is a need for further research on methods of delivering anesthetics to postoperative wounds for pain management and improving the quality of treatment.

The article deals with the main causes of chronic pelvic pain syndrome (CPPS), some of its pathogenetic mechanisms are depicted. It is noted that at the present time, CPPS, despite its considerable prevalence, remains poorly understood by a disease that is difficult to treat, the adequacy of which is possible only under the strict topical and nosological diagnostics. To date, there are no clearly identifiable etiological factors in the development of CPPS, and existing contradictory data regarding diagnostic criteria significantly reduce the possibility of a clear diagnosis. In addition, there is still no single approach to choosing the best treatment methods for CPPS, and the assessment of a large number of existing treatments for this disease is difficult due to the lack of a standardized system for evaluating the results of treatment. These circumstances, together with the steady course of the disease, lead to the formation of neurotic conditions, which emphasizes not only the purely medical but also the social significance of the problem of increasing the effectiveness of diagnosis and treatment of CPPS in boys at the present stage. The algorithm of diagnostics and treatment of CPPS is proposed, which is based on an individual and comprehensive examination of patients by multidisciplinary interaction with specialists of other specialties related to a specific case that allows choosing pathogenetically grounded treatment tactics

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The article presents data on the causes of the formation of various types of bezoars in children, traces the causes of their complicated course in the form of bezoar disease. Modern issues of diagnostics, methods of treatment and formation of foreign bodies of the digestive tract in children are covered in the article. A clinical case of a giant trichobezoar of the stomach and duodenum in a 14-year-old girl is presented and analyzed. in a histological examination of the gastric wall.

Endogenous intoxication, which accompanies the complicated course of acute appendicitis in children, is one of the serious conditions, which are the main cause of complications in the postoperative period. Diverse clinical observations done by clinicians suggest that despite the use of modern technologies in operating equipment, anesthetic support, the number of complications in the postoperative period has no tendency to decrease, and the main cause of lethal outcomes with appendicular peritonitis is lightning development of severe degree of endotoxicosis, which develops as a result of resorbing toxic substances formed of many components, including pathogenic microflora and destruction metabolism. Purpose. Creation of a mathematical model for prediction of complicated acute appendicitis in children using the functions of regression analysis of EXCEL spreadsheet by approximating experimental data. Materials and methods. In the work, there is information about 59 patients with acute appendicitis treated at the clinic of pediatric surgery at the National Pirogov Memorial Medical University. The data on patients were divided into two groups: patients with not complicated course of pathology – 24 patients, and patients with complicated course of acute appendicitis – 35 children. The control group served the data of 37 healthy children. In each of the three groups, the following parameters were studied: gender, age, bed day, duration of the disease, presence of symptoms of peritoneal irritation, the nature of exudate in the abdominal cavity, the number of red blood cells, hemoglobin, leukocytosis, quantitative characteristics of white blood formula, ESR, cellogenic endogenous intoxication: leukocyte index of intoxication and hematological index of intoxication. All the data were determined directly at the time of hospitalization of a patient to the hospital. Results. Discussion. Based on multiple correlation x = f (x1 , x2 ) a two-factor mathematical model of probability of the complicated course of acute appendicitis in children was created. According to the obtained results of the study of the system of three equations with three unknowns, it was established that if the indicator of the form of the disease is y = 2.67 and above, when, in numerical terms, the result falls into the zone of complicated flow of acute appendicitis and completely coincides with data analysis of the three groups of patients. Conclusions. The components that determine the uncomplicated course of acute appendicitis in children, according to the developed two-factor model, include LII and GPI, which exceed the values intoxication of certain intervals studied at the time of hospitalization. The analyzed indices were determined by the degree of severity of the pathological process, duration of disease, virulence of microflora and age of patients against the background of the formed endogenous intoxication syndrome.