Kaya Cengiz, Sener Elif Bengi, Koksal Ersin, Ustun Yasemin Burcu, Celik Handan, Sahinoglu Ali Haydar
J Pak Med Assoc. 2015 Jan;65(1):29-34.
To compare the effects of intrauterine lidocaine, intrauterine lidocaine plus rectal diclofenac, and a placebo on analgesia and to determine the satisfaction of patients and surgeons in cases of endometrial biopsy.
The double-blind, randomised, placebo-controlled study was conducted in the Department of Obstetrics and Gynaecology of the Ondokuz Mayis University, Samsun,Turkey, from April 2013 to January 2014, and comprised patients scheduled for in-office endometrial biopsy.They were divided into three groups: Group P, 5ml of 0.9% saline intrauterine; Group L, 5ml of 2% lidocaine intrauterine; and Group LD, 5ml of 2% lidocaine intrauterine ± 10min before the procedure plus 50mg of rectal diclofenac sodium. Haemodynamic changes and visual analogue scale scores were recorded during the preoperative period, when the cervix was grasped with a tenaculum, immediately after intrauterine instillation, during uterine curettage and at postoperative 10 min. The patient and the surgeon were questioned about their satisfaction 15 min after the procedure. SPSS 21 was used for statistical analysis.
The 90 patients in the study were divided into three equal groups of 30(33.33%) each. There were no statistically significant inter-group differences in age, bodyweight, parity, number of postmenopausal patients, haemodynamic parameters and American Society of Anesthesiologists scores (p>0.05 in all categories). In Group P, the visual analogue scale score estimated when the cervix was grasped with the tenaculum was lower when compared with Group L and Group LD (p=0.029 and p=0.007, respectively). At other measurement time points, the scores did not differ between the groups. The groups did not differ with respect to patient and surgeon satisfaction and complication rates (p>0.05).
Intrauterine lidocaine or intrauterine lidocaine plus rectal diclofenac application had no effect on visual analogue scale scores, patient satisfaction and vasovagal reaction.
比较宫腔内注射利多卡因、宫腔内注射利多卡因联合直肠用双氯芬酸及安慰剂对镇痛的效果，并确定在子宫内膜活检病例中患者和外科医生的满意度。
2013年4月至2014年1月，在土耳其萨姆松市翁多库兹迈伊斯大学妇产科进行了一项双盲、随机、安慰剂对照研究，纳入计划在门诊进行子宫内膜活检的患者。他们被分为三组：P组，宫腔内注射5ml 0.9%生理盐水；L组，宫腔内注射5ml 2%利多卡因；LD组，在操作前±10分钟宫腔内注射5ml 2%利多卡因加50mg直肠用双氯芬酸钠。在术前、用宫颈钳夹持宫颈时、宫腔内注入药物后立即、刮宫时及术后10分钟记录血流动力学变化和视觉模拟评分。术后15分钟询问患者和外科医生的满意度。采用SPSS 21进行统计分析。
研究中的90例患者被平均分为三组，每组30例（各占33.33%）。在年龄、体重、产次、绝经后患者数量、血流动力学参数和美国麻醉医师协会评分方面，组间差异无统计学意义（所有类别p>0.05）。在P组中，用宫颈钳夹持宫颈时估计的视觉模拟评分低于L组和LD组（分别为p=0.029和p=0.007）。在其他测量时间点，各组评分无差异。各组在患者和外科医生满意度及并发症发生率方面无差异（p>0.05）。
宫腔内注射利多卡因或宫腔内注射利多卡因联合直肠用双氯芬酸对视觉模拟评分、患者满意度和血管迷走神经反应无影响。
