Morphological justification of analgesia with the aim of hyperalgesia prevention in postoperative period in children operated on for tumors of abdominal cavity

Summary. In the article morphological changes of skin in the area of postoperative wound are displayed. Was discovered, that ­using of high fentanyl doses (10–20 µg/kg/h) by continuous infusion method for analgesia in the early postoperative period in children operated on for tumors of abdominal cavity, can result into opioid-induced hyperalgesia, which is followed by skin morphological changes around the postoperative wound with the development of necrosis in it center with expressed perifocal reactive changes in the form of severe inflammation and significant violations of microcirculation with the formation on the 14th day of small nerve fibers. In its turn by using of TAP-block and combined spinal-epidural analgesia method small perineural edema was determined, fragmentation of nerve fibers was not determined, which indicates the absence of development of postoperative period. Using of ketamine infusion results into negligible perineural edema and reduction of postoperative hyperalgesia.