Evaluation of analgesic therapy in the postoperative period in patients with surgical pathology of the stomach performed, according to the ERAS protocol

Introduction. Surgical treatment with mandatory pre- and postoperative chemotherapy remains the main method of treating stomach cancer. Despite the existence of various chemotherapeutic treatment regimens, there are few surgical treatment options: gastric resection and gastrectomy with dissection of regional lymph collectors. The main reason for the long postoperative recovery of patients is the severe pain syndrome. The use of multimodal analgesic therapy as a component of the ERAS protocol can accelerate the patient's recovery after surgery without reducing the quality of rehabilitation and reduce the patient's hospital stay.

Goal. To evaluate the effectiveness of multimodal analgesic therapy under the ERAS protocol in the postoperative period in patients with gastric pathology requiring radical surgical treatment.

Materials and methods. We analyzed the results of postoperative recovery and the features of analgesic therapy in the framework of the ERAS protocol in 84 patients undergoing surgical treatment at the Federal State Budgetary Scientific and Scientific Center of the FMBA of Russia in Krasnoyarsk from 2018 to 2025. To do this, we assessed the severity of pain syndrome in the postoperative period and compared the dynamics of postoperative pain reduction in different groups of patients, which was evaluated on a visual-analog scale.

Results. A total of 84 patients with gastric pathology requiring routine surgical treatment were examined. Each of the patients was ranked into one of four groups. A statistically significant relationship was found between the traumatic nature of surgery and postoperative pain syndrome on the second, third, fourth and fifth days of the postoperative period. All patients of the studied groups achieved a statistically significant (p<0.05) reduction in postoperative pain. There was a direct statistically significant relationship between body mass index and postoperative pain.

Discussion. The use of multimodal analgesic therapy within the framework of the ERAS protocol has shown its high effectiveness in relieving postoperative pain syndrome in patients with surgical pathology of the stomach, early expansion of patients' motor activity and reducing the use of narcotic analgesics.

Conclusion. The presented data confirm the expediency of using multimodal analgesia based on prolonged epidural blockade and paracetamol as part of the ERAS protocol for surgical patients. Further prospective randomized trials involving a larger number of patients and health care facilities are needed to obtain more convincing evidence.

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