Gafarov H.O., Shakirov M.N., Mirzoev M.Sh.

The department of maxillofacial surgery with children stomatology of TIPGPMP

Questionnaire of 108 patients with advanced stages of malignant tumors of maxillo-facial region studied the nature of the chronic pain syndrome and assessing the effectiveness of traditional pain therapy. The 58,3% of the observed diagnosed with advanced stage cancer of mucous membranes of the oral cavity, 23.1% of installed cancer of mucous membrane of the maxillary sinus, a 3.7% identified advanced stage of osteosarcoma jaws. The 3rd and the 4th stage of malignant process revealed respectively of 17.6% and 82.5% of the observed. Among patients with the character of the pain syndrome and effectiveness of the analgetic therapy were studied by the method of questioning on the specially prepared questionnaire. Study of the dynamics of pain syndrome showed that the pain intensified after their first appearance during the first 3 months of 20,3% of patients during 3-6 months — 37,0%in 6-12 months in 25,9%, later than 1 year — 16,6% of patients. Analysis of the nature of pain showed that 37.9% of persons they are «Ripper» character, 27.7% of «capturing», 23.1% of the «hot», 6,5% — «breaking», 4.6% — «whining». It is established that the pain syndrome in this category of patients is often neuropathic development mechanism, which explains the lack of effectiveness of pain therapy using drugs. The findings suggest the need for further improvement of the well-known methods and search for new, more effective methods of reduction of chronic pain syndrome in this category of patients.


1. V.L. Mihaloyvicha, Yu.D. Ignatova. L. Bolevoy sindrom [Pain syndrome]. Meditsina Publ., 1990. 336 p.

2. Bryuzgin V.V. Hronicheskiy bolevoy sindrom u onkologicheskikh bol'nykh (organizatsionno-metodicheskie aspekty). Diss. Dokt. med.nauk. [Chronic pain syndrome in oncologic patients (organizing-methodical aspects). Dr. med. Sci. diss.] Moscow, 1993. 267 p.

3. Vazhenin A.V., Sharabura T.M., Kosol-apov A.N. [Organizatsiya palliativnoy pomoshchi v regional’nom uchrezhdenii onkologicheskogo profilya]. Sbornik nauchnikh trudov «Aktu-al’nye teoreticheskie i prakticheskie aspekty voss-tanovleniya i sokhraneniya zdorov’ya cheloveka» [Actual theoretical and practical aspects of the reconstruction and conservations of health of the person] pod red.N.Ya. Prokop'eva. Tyumen': IPC «Ekspress», 2004, pp. 13.

4. Lebedeva R.N., Nikoda V.V. Farmakoter-apiya ostroy boli [Pharmacotherapy of acute pain]. Moscow, AIR ART Publ., 1998. 7-39 p.

5. Minimal'nye klinicheskie rekomendatsii Ev-ropeyskogo Obshhestva Meditsinskoy Onkologii (ESMO) [Minimum clinical recommendations European Society Medical Oncology (ESMO)]. Per. s angl. / pod red. S.A. Tyulyandina, k D.A. Nosova; N.I. Perevodchikova. Moscow, Izdatel'skaya gruppa RONC im. N.N. Blohina RAMN Publ., 2010. 279-282 p.

6. Novikov G.A., Osipova N.A. Lechenie khronicheskoy boli onkologicheskogo geneza: uchebnoe posobie [Treatment of chronic pain oncologic genesis: scholastic allowance]. Pod red. G.A. Novikova, N.A. Osipovoy. Moscow, OOD «Medicina za kachestvo zhizni» Publ., 2005. 84 p.

7. Obezbolivanie i palliativnaya pomoshch' pri rake. Otchet Jekspertnogo komiteta VOZ [Anes­thetization and palliative help at cancer. Report of the Expert committee WOPH]. Zheneva, VOZ Publ., 1990. 76 p.

8. Opukholevye boli — poetapnaya skhema VOZ Pharmedicum [Cancer pains — a phased scheme WOPH Pharmedicum]. 1995. Vol.1, 9-11p.

9. Osipova N.A., Novikov G.A., Prohorov B.M. Hronicheskij bolevoj sindrom v onkologii [Chronic pain syndrome in oncology]. Moscow, Meditsina Publ., 1998. 178 p.

10. Fedjaev I.M., Bajrikov I.M., Belova L.P., T.V. Shuvalova. Zlokachestvennye opuholi chel-justno-licevoj oblasti [Malignancies maxillofacial region]. Moscow, Medicinskaja kniga Publ., Nizhnii Novgorod, NGMD Publ., 2000. 160 p.

11. Chissov V.I., Starinskij V.V., Petrova G.V. Sostojanie onkologicheskoj pomoshhi naseleniju Rossii v 2010 godu [Condition oncologic help to population of Russia in 2010]. Moscow, FGU «MNIOI im. P.A. Gercena» Minzdravsocrazvi-tija Rossii Publ., 2011. 188 p.

12. Shakirov M.N., Murodov A.M., Akbarov M.M., Gafarov H.O., Mirzoev M.Sh., Dzhonibe-kova R.N. K voprosu o sovershenstvovanii metodov lechebnogo obezbolivanija u bol'nyh s zapushhennymi stadijami razvitija zlokachest-vennyh opuholej cheljustno-licevoj oblasti [To question about improvement of the methods of the medical anesthetization in patients with un­cared-for stages of the development of the malig­nancies maxillofacial region]. Zdravoohranenie Tadzhikistana, 2010, no. 4. 155-159 p.

13. Cancer pain relief and palliative care. Report of a World Expert Committee. Geneva, WHO Publ., 1990. 70 p.

14. Doyle D. Domiciliary palliative care. The Oxford Textbook of palliative / D. Doyle, G.W.

Hanks, MacDonald & (editors). Medicine. 2nd edition. Oxford: Oxford Medical Publications, 1998. 310-331 p.

15. Dray A. Agonists and antagonists of nociceptor: Proceedings of the 8th Congress of pine. Vancouver. Seattle, JASP Press Publ., 1996. 279-292 p.

16. Foley K.M. Pain assessment and cancer pain syndromes. The Oxford Textbook of pal­liative / D. Doyle, G.W. Hanks, MacDonald & (editors). Medicine. 2nd edition. Oxford: Oxford Medical Publications, 1998. 310-331 p.

17. Kehlet H. Multimodal approach to control histoperative patophysiology and rehabilitation // Br. J. Anesth. 1997. Vol. 78. 606-617 pp.

18. Kehlet H. Controlling acute pain — role of preemptive analgesia, peripherial treatment, balanced analgesia and effects on outcome (Цит. По Max M. (Ed). Pain 1999. An Updated Re­view. Seattle, IASP Press Publ., 1999. 459-462 p.

19. Mannion R., Woolf C. Pain mechanisms and management: a central perspective . Clin. J. Pain. 2000, Vol. 16, №3. pp. 144-156.

20. Martin W.R. Pharmacology of Opioids // Pharmacol. Rew. 1984. Vol. 35. 283-322 p.

21. Stabhaug A., Breivik H., Eide P.K., et al. Ketamine reduce postoperative hyperalgesia. Proceedings of the 8th Congress of pine. Van­couver. Seattle: JASP Press, 1996. 333-342 p.

Information about the authors:

Gafarov Khurshedjan Olimjanovich — the post­graduate of department of maxillofacial surgery with pediatric stomatology TIPGPMP; Tel: (+992) 927806737; e-mail:


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