Lee Jiyoung, Lee Seunghoon, Lee Heungwoo, Kim Hyeon Chul, Park Chunghyun, Kim Jong Yeop
Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam.
Department of Medical Sciences, Graduate School of Ajou University, Suwon.
Medicine (Baltimore). 2020 Oct 16;99(42):e22751. doi: 10.1097/MD.0000000000022751.
The use of hysteroscopy for the diagnosis and treatment of uterine and endometrial abnormalities is often associated with postoperative pain. This randomized controlled trial aimed to assess the efficacy of preoperative intravenous (IV) lidocaine in reducing pain after hysteroscopy.
In total, 138 patients undergoing elective hysteroscopy at the CHA Bundang Medical Center, Seongnam, Korea were randomly assigned to a control group (n = 69) or a lidocaine group (n = 69), which received normal saline or IV lidocaine at 1.5 mg/kg, respectively. The primary outcome was the incidence of postoperative pain.
The incidence of pain was significantly lower in the IV lidocaine group than in the control group at the post-anesthesia care unit (27.3% vs 68.2%, P < .001). The visual analog scale (0-10) score (median [interquartile range]) was lower in the IV lidocaine group than in the control group (0 [0-2]) vs 2 [0-4]), P < .001). The use of rescue analgesics and postoperative nausea and vomiting were similar between the 2 groups. This study demonstrated that administering 1.5 mg/kg of preoperative IV lidocaine can be a simple method to reduce incidence of pain after hysteroscopy.
Preoperative bolus administration of 1.5 mg/kg of IV lidocaine may be used to decrease incidence of pain after hysteroscopy under general anesthesia.
宫腔镜检查用于诊断和治疗子宫及子宫内膜异常时，术后疼痛较为常见。本随机对照试验旨在评估术前静脉注射利多卡因对减轻宫腔镜检查术后疼痛的效果。
韩国城南CHA盆唐医疗中心共有138例行择期宫腔镜检查的患者，随机分为对照组（n = 69）和利多卡因组（n = 69），分别给予生理盐水或1.5 mg/kg静脉注射利多卡因。主要观察指标为术后疼痛的发生率。
在麻醉后护理单元，静脉注射利多卡因组的疼痛发生率显著低于对照组（27.3%对68.2%，P <.001）。静脉注射利多卡因组的视觉模拟评分（0 - 10）（中位数[四分位数间距]）低于对照组（0[0 - 2]对2[0 - 4]），P <.001）。两组间急救镇痛药的使用及术后恶心呕吐情况相似。本研究表明，术前静脉注射1.5 mg/kg利多卡因是降低宫腔镜检查术后疼痛发生率的一种简单方法。
术前静脉推注1.5 mg/kg利多卡因可用于降低全身麻醉下宫腔镜检查术后的疼痛发生率。
