Meckstroth Karen R, Mishra Kavita
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.
Clin Obstet Gynecol. 2009 Jun;52(2):160-70. doi: 10.1097/GRF.0b013e3181a2b0e8.
Management of pain during abortion is a critical aspect of patient care. Although it is not always possible to offer a range of pain control options in every setting, individualizing pain medications as much as possible for patients' preferences is likely to improve satisfaction with the abortion experience. Evidence suggests that higher volume (at least 200 mg lidocaine) and deeper injections are beneficial for cervical block. Adding intravenous sedation with a moderate dose of fentanyl and midazolam reduces the pain scores. Oral benzodiazepines may improve satisfaction and anxiety. Deep sedation and general anesthesia are important options for women with significant medical conditions or complicated procedures.
流产期间的疼痛管理是患者护理的关键环节。尽管并非在每种情况下都能提供一系列疼痛控制选择,但尽可能根据患者偏好个体化使用止痛药物可能会提高对流产体验的满意度。有证据表明,较大剂量(至少200毫克利多卡因)和更深的注射对宫颈旁阻滞有益。添加中等剂量芬太尼和咪达唑仑的静脉镇静可降低疼痛评分。口服苯二氮䓬类药物可能会提高满意度并减轻焦虑。深度镇静和全身麻醉是患有严重疾病或手术复杂的女性的重要选择。