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宫颈旁阻滞对全麻下人工流产术后疼痛的影响。

Impact of paracervical block on postabortion pain in patients undergoing abortion under general anesthesia.

机构信息

Department of Obstetrics and Gynecology, University of Hawaii John A Burns School of Medicine, Honolulu, HI 96821, USA.

出版信息

Contraception. 2009 Dec;80(6):578-82. doi: 10.1016/j.contraception.2009.05.125. Epub 2009 Jul 10.

Abstract

BACKGROUND

Paracervical block is used as a way to decrease postoperative pain in patients having abortions under general anesthesia. To date, no studies have evaluated the efficacy of this practice.

STUDY DESIGN

Patients were recruited from a university-based family planning clinic. Seventy-two patients seeking abortion under general anesthesia were enrolled into the single-blinded study. Thirty-nine patients were randomized to receive a paracervical block, and 33 were randomized to no local anesthesia. The patients completed a demographic survey and visual analog pain scales for pain prior to and at several time points after the procedure. Data regarding the need for additional pain medications postoperatively were recorded. Analysis of variance single factor and two-sample one-sided t test were used in data analysis.

RESULTS

Experimental and control groups were similar in all measured demographic characteristics. They were also similar in gestational age, number of laminaria required, preoperative dilation, operative time, estimated blood loss and reported complications. Postoperative pain was not significantly affected by placement of a paracervical block prior to abortion under general anesthesia. The need for postoperative pain medication during recovery was similar between groups.

CONCLUSION

This study does not support the hypothesized benefit of local anesthesia prior to surgical abortion under general anesthesia to reduce postoperative pain.

摘要

背景

子宫旁阻滞被用于减轻全麻下人工流产术后疼痛。迄今为止,尚无研究评估这种方法的效果。

研究设计

患者从一所大学计划生育诊所招募。72 名在全麻下接受流产的患者被纳入这项单盲研究。39 名患者被随机分配接受子宫旁阻滞,33 名患者被随机分配不接受局部麻醉。患者完成了人口统计学调查和视觉模拟疼痛量表,以评估术前和术后几个时间点的疼痛。记录了术后需要额外止痛药的数据。数据分析采用单因素方差分析和两样本单侧 t 检验。

结果

实验组和对照组在所有测量的人口统计学特征方面相似。两组在妊娠年龄、所需的米索前列醇数量、术前扩张、手术时间、估计出血量和报告的并发症方面也相似。全麻下人工流产前放置子宫旁阻滞并不显著影响术后疼痛。两组患者在恢复期间对术后止痛药的需求相似。

结论

本研究不支持在全麻下进行手术流产前局部麻醉可减轻术后疼痛的假设。

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