The use of regional anesthetic techniques in abdominal surgery is an essential component of the multimodal approach to perioperative analgesia, yet data on their use in obese patients remains limited. The aim of this study is to determine the effectiveness of the epidural analgesia (EA) and the transversus abdominis plane block (TAP-block) in laparoscopic obese patients, as well as to evaluate the possibility of using the rectus sheath block (RSB) as a "rescue" anesthetic technique after laparotomy in obese patients. Materials and methods. The data on the 102 obese patients operated on esophageal hiatal diaphramgmatic hernia, colon tumor, postoperative ventral hernia, morbid obesity and choledocholithiasis were analyzed. In laparoscopic surgery 20 patients received EA (EA group), 21 patients-TAP-block (TAP group), 21 patients-opioids and non-steroidal anti-inflammatory drugs (NSAIDs) without any regional anesthesia techniques (group TIVA 1). In laparotomic surgery 16 patients received RSB (RSB group) and 24 patients-only opioids and NSAIDs (TIVA 2 group). After the surgery the following was estimated: the time of extubation, the total dose of opioids, the level of pain according to the 10-point numeric range score (NRS), the incidence of dyspnea using the monitor Utas 300 (Ukraine), the incidence of postoperative nausea and vomiting (PONV), the time of active patient mobilization, and the level of satisfaction with analgetic regimen. For the RSB group, the complexity of the RSB and the mean time to achieve adequate analgesia (pain intensity ≤3 points per NRS) were determined additionally. The statistical analysis was performed using the Statistica for Windows version 6.0 software. Results. In the EA group, the intraoperative dose of fentanyl was twice lower, and patients were extubated two times faster than in the TAP, TIVA 1 , RSB, TIVA 2 groups (P < 0.05). At the same time, none of the patients in the EA group required the restoration of neuromuscular conduction with neostigmine (P < 0.05). After the surgery, the pain level was 2-3 times higher in the TIVA 1 , RSB, and TIVA 2 groups than in the EA and TAP groups (P < 0.05). "Rescue" analgesia in the RSB group was performed from the first attempt in all the patients in 5-10 minutes and provided an adequate effect in 3 (2-4) min. The complexity level of RSB was defined as "easy" in 12 (75 %) patients, as "average" in 4 (25 %) patients (P < 0.05). The incidence of dyspnea and opioid doses after surgery in the EA, TAP and RSB groups of patients were 2 times lower, and the incidence of PONV was 3 to 4 times lower than in the TIVA 1 and TIVA 2 patients' groups (P < 0.05). In the EA and TAP groups, patients became mobile after 8-13 hours after surgery, in the group TIVA 1-after 16-22 hours, in the group RSB-after 18-36 hours, in the group TIVA 2-after 48-96 hours (P < 0.05). 100 % of the respondents from the EA, TAP and RSB groups were satisfied with the analgesic regimen at the "excellent-good" level. In the TIVA 1 and TIVA 2 groups, 20-25 % of respondents identified...

The development of the agrarian sector of the economy, as well as of the entire national economy, should be based on a clear and consistent state regulatory policy. Rent is one of the most effective financial instruments for regulating the development of the agrarian sector. As a whole, rent is defined as the income of any resources (production factors) owner that is not related to business activity. Onwards, economic rent is an over-income that the owner receives from using a variety of quality resources, the supply of which is limited in the long run. From the financial point of view, rent is part of the entrepreneur's income, his unearned income. The consequence of excessive and uncontrolled macro-level rent-seeking behavior is the so-called «Dutch disease», which causes concentration of labor and capital in the services sector, its outflow from the real economy and the simultaneous replacement with unproductive inputs. It is determined that the rent saturation of the GDP of Ukraine exceeds the world average values, that designates the national economy as a commodity one, testifies to the developmental, transitive nature of the economy, its direct dependence on the developed countries. Moreover, the dynamics of the annual indices of the physical volume of Ukraine's GDP coincides with the dynamics of its rent withdraw, which shows the direct dependency of goods production and rent, thus defining the economic system as extensive and reindustrialized. It is proved that amid non-renewable natural resources depletion, the economy of Ukraine is losing its potential and without drastic transformations, changes in technological structure and development of vertical integration, the crisis will only deepen. The implementation of the proposed measures will contribute to the return of rental over-income to those who have a constitutional right to get it, will provide additional financial resources to fulfill local budgets, especially rural territorial communities.

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