Duros Solène, Joueidi Yolaine, Nyangoh Timoh Krystel, Boyer Laurence, Lemeut Paul, Tavenard Aude, Laviolle Bruno, Levêque Jean, Lavoué Vincent
University of Rennes 1, Faculty of Medicine, F-35043 Rennes, France; CHU Rennes, Department of Gynecology and Obstetrics, F-35033 Rennes, France.
CHU Rennes, Department of Gynecology and Obstetrics, F-35033 Rennes, France.
Eur J Obstet Gynecol Reprod Biol. 2018 Feb;221:123-128. doi: 10.1016/j.ejogrb.2017.12.024. Epub 2017 Dec 15.
To determine the frequency of severe pain among women and to identify the associated predictive factors during first-trimester surgical abortion under local anaesthesia (LA).
A prospective cohort study from November 2013 to January 2014 at the Department of Gynecology and Obstetrics, Rennes, France. The study population was composed of one hundred and ninety-four patients who underwent an elective first-trimester surgical abortion under LA. In an anonymized questionnaire, the participants were asked to self-record their perceived pain level 30 min after the completion of the procedure using a 10 cm visual analogue scale (VAS). The main outcome measure was the frequency of severe pain among women, defined as VAS ≥ 7. Secondary outcome measure was the risk factor(s) for severe pain.
Severe pain (i.e. VAS ≥ 7) was experienced by 46% (95% CI: 39%-53%) of the population. Multivariate analysis confirmed that >10 weeks of gestation (OR: 2.530 [95% CI: 1.1-5.81], p = .0287) and having 0 or 1 child (OR: 5.206 [95% CI: 1.87-14.49], p = .0016) were significant independent factors of severe pain.
Nearly half of the women experienced severe pain. More than 10 weeks of gestation and parity were predictive factors of severe pain. These findings should be useful in counselling women undergoing surgical abortion under LA.
确定在局部麻醉下进行孕早期人工流产手术的女性中严重疼痛的发生率，并识别相关的预测因素。
2013年11月至2014年1月在法国雷恩市妇产科进行的一项前瞻性队列研究。研究人群由194例在局部麻醉下接受择期孕早期人工流产手术的患者组成。在一份匿名问卷中，要求参与者在手术完成30分钟后使用10厘米视觉模拟量表（VAS）自行记录其感知的疼痛程度。主要结局指标是女性中严重疼痛的发生率，定义为VAS≥7。次要结局指标是严重疼痛的危险因素。
46%（95%可信区间：39%-53%）的人群经历了严重疼痛。多因素分析证实，妊娠>10周（比值比：2.530 [95%可信区间：1.1-5.81]，p = 0.0287）和子女数为0或1个（比值比：5.206 [95%可信区间：1.87-14.49]，p = 0.0016）是严重疼痛的显著独立因素。
近一半的女性经历了严重疼痛。妊娠超过10周和产次是严重疼痛的预测因素。这些发现对于为在局部麻醉下进行人工流产手术的女性提供咨询应是有用的。
