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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">pirogovestnik</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник Национального медико-хирургического центра им. Н.И. Пирогова</journal-title><trans-title-group xml:lang="en"><trans-title>Bulletin of Pirogov National Medical &amp; Surgical Center</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2072-8255</issn><issn pub-type="epub">2782-3628</issn><publisher><publisher-name>Национальный медико-хирургический Центр им. Н.И. Пирогова</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.25881/20728255_2025_20_3_49</article-id><article-id custom-type="elpub" pub-id-type="custom">pirogovestnik-358</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>ЭФФЕКТИВНОСТЬ НЕОПИОДНЫХ АНАЛЬГЕТИКОВ У ПАЦИЕНТОВ С ТРАВМАТИЧЕСКИМИ АМПУТАЦИЯМИ КОНЕЧНОСТЕЙ В РАННЕМ ПОСЛЕОПЕРАЦИОННОМ ПЕРИОДЕ</article-title><trans-title-group xml:lang="en"><trans-title>EFFICIENCY OF NON-OPIOID ANALGESICS IN PATIENTS WITH TRAUMATIC LIMB AMPUTATIONS IN THE EARLY POSTOPERATIVE PERIOD</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Крайнюков</surname><given-names>П. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Kraynyukov</surname><given-names>P. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ким</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kim</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p> Москва </p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гудантов</surname><given-names>Р. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Gudantov</surname><given-names>R. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Борисова</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Borisova</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">aribor.borisova@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Агафонов</surname><given-names>Д. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Agafonov</surname><given-names>D. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p> Москва </p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Крайнюков</surname><given-names>Е. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Kraynyukov</surname><given-names>E. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Волгоград</p></bio><bio xml:lang="en"><p>Volgograd</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФКУ «Центральный военный клинический госпиталь им. П.В. Мандрыка»; &#13;
ФГАОУ ВО «Российский университет дружбы народов им. Патриса Лумумбы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Central Military Clinical Hospital named after P.V. Mandryka;&#13;
Peoples’ Friendship University of Russia named after Patrice Lumumba</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФКУ «Центральный военный клинический госпиталь им. П.В. Мандрыка»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Central Military Clinical Hospital named after P.V. Mandryka</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБУ «413 ВГ Минобороны России»;&#13;
Институт общественного здоровья им. Н.П. Григоренко Волгоградского государственного медицинского  университета</institution><country>Россия</country></aff><aff xml:lang="en"><institution>413 Military Group;&#13;
Institute of Public Health named after N.P. Grigorenko Volgograd State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>29</day><month>08</month><year>2025</year></pub-date><volume>20</volume><issue>3</issue><fpage>49</fpage><lpage>52</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Крайнюков П.Е., Ким Е.А., Гудантов Р.Б., Борисова А.В., Агафонов Д.Е., Крайнюков Е.П., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Крайнюков П.Е., Ким Е.А., Гудантов Р.Б., Борисова А.В., Агафонов Д.Е., Крайнюков Е.П.</copyright-holder><copyright-holder xml:lang="en">Kraynyukov P.E., Kim E.A., Gudantov R.B., Borisova A.V., Agafonov D.E., Kraynyukov E.P.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://submit.pirogov-vestnik.ru/jour/article/view/358">https://submit.pirogov-vestnik.ru/jour/article/view/358</self-uri><abstract><p>Обоснование: данная работа является интеграцией более безопасных и эффективных препаратов в клиническую практику для оптимизации обезболивания и снижения рисков, связанных с использованием традиционных опиоидных анальгетиков.Цель исследования: оценить эффективность обезболивания в раннем послеоперационном периоде с использованием неопиоидных анальгетиков (ибупрофен, тафалгин, нефопам) у пациентов с минно-взрывными ранениями (МВР), сопровождающимися травматическими ампутациями конечностей.Методы: в исследование включены 45 пациентов, случайным образом распределенных на три группы в зависимости от используемого анальгетика: ибупрофен, тафалгин или нефопам.Результаты: во всех группах наблюдалось существенное снижение потребности в дополнительной послеоперационной анальгезии, включая опиоидные препараты. Нефопам обеспечивал наиболее выраженный анальгетический эффект, снижая интенсивность боли по шкале ВАШ сильнее, чем ибупрофен и тафалгин. Однако его применение сопровождалось более высокой частотой побочных эффектов (головокружение, тахикардия, гипертензия). Ибупрофен продемонстрировал оптимальное сочетание анальгетической эффективности и безопасности, с минимальной частотой побочных эффектов.Заключение: нефопам обладает выраженным анальгетическим эффектом в раннем послеоперационном периоде у пациентов с МВР, однако связан с повышенной частотой побочных эффектов. Ибупрофен показал высокий уровень безопасности и достаточную эффективность, что делает его предпочтительным компонентом мультимодальной аналгезии для данной категории пациентов.</p></abstract><trans-abstract xml:lang="en"><p>Justification: This work is the integration of safer and more effective drugs into clinical practice to optimize pain relief and reduce the risks associated with the use of traditional opioid analgesics.Objective: to evaluate the effectiveness of pain relief in the early postoperative period using non-opioid analgesics (ibuprofen, tafalgin, nefopam) in patients with mine-blast wounds (MBW) accompanied by traumatic amputations of the limbs.Methods: The study included 45 patients randomly assigned to three groups depending on the analgesic used: ibuprofen, tafalgin or nefopam.Results: In all groups, there was a significant decrease in the need for additional postoperative analgesia, including opioid drugs. Nefopam provided the most pronounced analgesic effect, reducing pain intensity on the VAS scale more than ibuprofen and tafalgin. However, its use was accompanied by a higher frequency of side effects (dizziness, tachycardia, hypertension). Ibuprofen demonstrated an optimal combination of analgesic efficacy and safety, with a minimal frequency of side effects.Conclusion: Nefopam has a pronounced analgesic effect in the early postoperative period in patients with MVR, but is associated with an increased frequency of side effects. Ibuprofen showed a high level of safety and sufficient efficacy, which makes it a preferred component of multimodal analgesia for this category of patients.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>нефопам</kwd><kwd>ибупрофен</kwd><kwd>тафалгин</kwd><kwd>боль в раннем послеоперационном периоде</kwd><kwd>управление болью</kwd></kwd-group><kwd-group xml:lang="en"><kwd>nefopam</kwd><kwd>ibuprofen</kwd><kwd>tafalgin</kwd><kwd>pain in the early postoperative period</kwd><kwd>pain management</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Small C, Laycock H. Acute postoperative pain management. Journal of British Surgery. 2020; 107(2): e70-e80.</mixed-citation><mixed-citation xml:lang="en">Small C, Laycock H. Acute postoperative pain management. 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