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宫腔镜手术中甘氨酸的吸收:麻醉的影响

Glycine absorption in operative hysteroscopy: the impact of anesthesia.

作者信息

Bergeron Marie-Eve, Beaudet Christine, Bujold Emmanuel, Rhéaume Caroline, Ouellet Pascale, Laberge Philippe

机构信息

Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de Québec, Faculty of Medicine, Université Laval, Québec City, QC, Canada.

出版信息

Am J Obstet Gynecol. 2009 Mar;200(3):331.e1-5. doi: 10.1016/j.ajog.2008.12.024.

Abstract

OBJECTIVE

This study aimed to evaluate the impact of anesthesia on the absorption of glycine in operative hysteroscopy.

STUDY DESIGN

A retrospective cohort study was performed over 2 years. The absorption of glycine was compared among general anesthesia, local anesthesia with intravenous sedation, and spinal anesthesia. Multiple logistic regression analyses were performed.

RESULTS

In all, 282 operative hysteroscopies were reviewed. The median absorption was 145 mL (10th-90th centile: 0-963 mL) for general anesthesia, 35 mL (10th-90th centile: 0-389 mL) for local anesthesia, and 100 mL (10th-90th centile: 0-500 mL) for spinal anesthesia (P = .002). In comparison with general anesthesia, local anesthesia was associated with lower rate of absorption of 500-1000 mL (4.2% vs 13.4%) and of 1000-1500 mL (3.6% vs 9.8; P = .002). Laparoscopic tubal ligation performed during the procedure was also associated with higher glycine absorption (odds ratio, 3.63; 95% confidence interval, 1.12-11.84).

CONCLUSIONS

Local anesthesia with sedation is associated with significantly decreased glycine absorption and lower rate of absorption > 500 mL when compared with general anesthesia.

摘要

目的

本研究旨在评估麻醉对宫腔镜手术中甘氨酸吸收的影响。

研究设计

进行了一项为期2年的回顾性队列研究。比较了全身麻醉、静脉镇静下局部麻醉和脊髓麻醉中甘氨酸的吸收情况。进行了多项逻辑回归分析。

结果

总共回顾了282例宫腔镜手术。全身麻醉的中位吸收量为145毫升(第10百分位数-第90百分位数:0-963毫升),局部麻醉为35毫升(第10百分位数-第90百分位数:0-389毫升),脊髓麻醉为100毫升(第10百分位数-第90百分位数:0-500毫升)(P = 0.002)。与全身麻醉相比,局部麻醉与500-1000毫升(4.2%对13.4%)和1000-1500毫升(3.6%对9.8;P = 0.002)的较低吸收速率相关。手术过程中进行的腹腔镜输卵管结扎也与较高的甘氨酸吸收相关(优势比,3.63;95%置信区间,1.12-11.84)。

结论

与全身麻醉相比,镇静下局部麻醉与甘氨酸吸收显著降低以及吸收量>500毫升的较低发生率相关。

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