Chronic postsurgical pain (CPSP) is defined as pain that develops or increases in intensity after a surgical procedure and persists for at least three months. Its prevalence rate ranges from 5% to 54%. Aim - to assess the prevalence of CPSP among children at the age of 7-18 years residing in the Precarpathian region at three and six months after herniorrhaphy, orchiopexy and Bernardi procedure. Materials and methods. There were observed 92 children at the age of 7-18 years, who underwent treatment for abdominal wall hernia, cryptorchidism, varicocele, and hydrocele at the surgical department. Children were divided into the following groups: Group 1a included children at the age of 7-12 years with acute pain syndrome in the postoperative period; Group 1b comprised children at the age of 13-18 years with acute pain syndrome in the postoperative period; Group 2a included children at the age of 7-12 years with chronic pain syndrome; Group 2b included children at the age of 13-18 years with chronic pain syndrome. Results. The prevalence of CPSP following surgery among children of the Precarpathian region was found to be 33.7%, with a male predominance (р<0.05). There was an increased need for postoperative pain management with paracetamol in children of Group 2a (р<0.05). The mean scores of the Face, Legs, Activity, Cry, Consolability (FLACC) scale were significantly higher in children of Group 2a, 2b as compared to Group 1a, 1b (р<0.05). The Visual Analogue Scale (VAS) confirmed greater pain intensity in children of Group 2a on the second and third days of treatment (р<0.05). Conclusions. The high prevalence of chronic pain in children after herniorrhaphy, orchiopexy by Petrivalsky / Schoemaker technique, Ross and Bernardi procedures is due to ineffective perioperative pain management that requires the use of additional analgesia techniques, including regional ones. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

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Мета: проаналізувати клініко фенотипові та генеалогічні дані у хворих з нейрофіброматозом I типу; розрахувати популяційну частоту захворювання та частоту мутацій de novo на Прикарпатті. Матеріали і методи. Проаналізовані випадки нейрофіброматозу I типу за період з 1998 по 2018 рр., що зареєстровані в обласному медико генетичному центрі, карти стаціонарних хворих окремих пацієнтів, які лікувалися в онкогематологічному відділенні. У роботі використано наступні методи: клініко генеалогічний, загальноклінічні, рентгенологічні, у т. ч. комп'ютерна або магнітно резонансна томографія, статистичні методи. Результати. Нейрофіброматоз I типу діагностовано у 75 сім'ях. Питома вага та частота мутацій de novo в етіології захворювання є досить високою: 65% та 7,59х10 5 відповідно. У значній кількості випадків (38%) діагноз встановлено досить рано, до семирічного віку, коли ще немає повної клінічної картини. Описано випадок гігантської нейрофіброми плеча, шиї з поширенням у плевральну порожнину та середостіння, у поєднанні з гамартоматозними вогнищами у головному мозку у дитини раннього віку. Висновки. Нейрофіброматоз I типу є найбільш поширеним факоматозом на Прикарпатті. У більшості випадків захворювання виникає внаслідок мутацій de novo (65%), що може бути використано для оцінки мутагенного впливу довкілля. Ключові слова: нейрофіброматоз, діти, мутації de novo, Прикарпаття.

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Introduction. Pain is a signal to any aggression that leads to cellular damage and requires a defensive response. Uncontrolled acute perioperative visceral pain can lead to the development of pain chronicity. By studying the characteristics of chronic pain, some scientists have identified relationships with single-nucleotide polymorphisms of the beta2-adrenergic receptor (ADRB2) gene. Purpose - to study the dependence of pain expression in the postoperative period in children on the polymorphism of the molecular structure of the ADRB2 receptor. Materials and methods. The study involved 42 children (20 boys and 22 girls) aged 7 to 18 years who were treated in the surgical department in 2020-2022 for acute appendicitis and peritonitis. Results. Based on the results of examining all the subjects under study, 13 children had the Arg16Gly polymorphism, 15 children had the Arg16Gly polymorphic variant, and 14 children were diagnosed with the homomorphic Gly16Gly polymorphism in the ADRB2. The data obtained confirmed the trend of the preliminary analysis and proved better body response to pain relief and reduced pain intensity in individuals with the Arg16Arg variant of the ADRB2. Analysis of the dependence between the polymorphism of the ADRB2 molecular structure and Visual Analogue Scale (VAS) scores in children in the postoperative period proved that the presence of Arg in the receptor phenotype had a strong negative correlation with the VAS score on discharge day (r=-0.822, p<0.001), while the presence of Gly in the receptor phenotype had a strong positive correlation with the Visual Analogue Scale score on discharge day (r=0.814, p<0.001). In regression analysis, the presence of Gly in the receptor phenotype was associated with a 1.917-fold increase in the VAS score at hospital discharge (OR: 1.917; 95% CI: 1.448-2.385; р<0.001). Conclusions. The presence of the homomorphic Arg16Arg variant of the ADRB2 in children who underwent anterior abdominal wall surgery was accompanied by rapid response to analgesics. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.