Influence of the choice of tactics of surgical treatment of victims with battle lesions of the lower limb on their psycho-emotional status

The analysis of the verbal-communicative state, psycho-emotional status and quality of life of 156 victims who received gunshot wounds of the lower extremities as a result of combat operations was carried out. Retrospectively, the wounded included in the study were divided into groups IV, depending on the anesthesia performed: Group I (39 people) surgery was performed under local infiltration anesthesia with 0.25% lidocaine solution. The volume of injected local anesthetic did not exceed the maximum toxic dose. Group II (40 people) performed conduction anesthesia of peripheral nerves under ultrasound control with Ropivacaine solution 0.5% -10 ml + Lidocaine solution 2%-10 ml. The variant of the blockade depended on the level of limb injury and operational access. The total volume of local anesthetic did not exceed 20 ml. Group III (38 people) - surgery was performed under conditions of prolonged conduction anesthesia. Under ultrasound control, taking into account the site of injury and surgical intervention, a catheter was inserted through the needle to the peripheral nerve, Articaine solution 1% - 5 was used, 0 ml followed by its prolonged administration through an infusomat at a rate of 1-2 ml/hour for 4-5 days. Group IV (39 people) - surgical intervention was performed under intravenous anesthesia (1% propofol solution and 0.005% fentanyl solution were used in an individual dosage based on the ratio of body weight and the duration of the operation). The result of the study showed that the most pronounced dynamics of health criteria according to the visual analogue scale (EQ VAS) and the data of "well-being” and "mood” of the differential self-assessment test "SAN” was noted in group III of patients who underwent surgery under conditions of prolonged conduction anesthesia under ultrasound control. Key words: gunshot wound, surgical treatment, lower limb, anesthetic benefit, prolonged conduction anesthesia, quality of life, visual analogue scale of pain.