Relevance The article presents the data of the original research to assess the clinical effectiveness of prevent and eliminate intraoperative pain syndrome program during coronary stenting in patients with nonstable angina pectoris (acute coronary syndrome). The purpose of the study Improving the efficiency of complex anti-stress protection of the organism in the surgical treatment of acute ischemic heart diseases with coronary syndrome by improving intraoperative anesthetic management. Materials and methods Clinical supervision included 200 cardiology patients (with concomitant acute coronary syndrome) with indications for coronary artery stenting. Among the investigated contingent highlighted two contrasting groups. 100 patients were included in the control group (using traditional program of analgesia). Other 100 patients were included in the basic group (using the developed program of analgesia). Methods of the research: assessment of the intensity of pain using modern analogue scales (visual analogue scale, digital rating scale) to assess the level of stress voltage of the autonomic nervous system by cardiointervalography with mathematical analysis of cardiac rhythm; descriptive and variational statistical methods to determine the level of significance of intergroup differences. Results and their discussion In the basic group identified the best level of analgetic protection and neurovegetative stabilization. Proved possible to complete prevention of intraoperative pain in the studied conditions. All identified intergroup differences have a high level of statistical significance. Conclusion The obtained results allow us to: statistically reasonably considered developed program of analgesia as a means of optimizing the anti-stress support for coronary stenting (with concomitant acute coronary syndrome), recommend it to practical application. Key words Intra-operative pain syndrome, acute coronary syndrome, coronary stenting, preemptive and multimodal analgesia, surgical stress, neurovegetative status