Department of Gynecology and Obstetrics, Marmara University School of Medicine, Turkey.
Department of Obstetrics and Gynecology, Ataturk University, Erzurum, Turkey.
Ginekol Pol. 2021;92(12):844-849. doi: 10.5603/GP.a2021.0058. Epub 2021 Apr 29.
OBJECTIVES: In recent years, lidocaine infusion for pain management during long operations is becoming more widespread in anesthesiology practice. However, only a limited number of studies have reported the intravenous use of lidocaine for short-term interventions. The aim of this study was to investigate the effectiveness of intravenous lidocaine use in pain management during colposcopic cervical biopsy and endocervical curettage (ECC). MATERIAL AND METHODS: Patients between the ages of 18 and 65 years with abnormal cytological findings or who were determined to be human papillomavirus (HPV)-positive were included in this randomized double-blind study. The lidocaine group (Group L, n = 30) was intravenously administered 50 mg dexketoprofen + 1.5 mg/kg lidocaine in 10 mL saline for 3 min 30 min before the procedure. The control group (Group C, n = 30) was intravenously administered 50 mg dexketoprofen in 10 mL saline for 3 min, 30 min before the procedure. During the procedure, pain scores were assessed using the visual analogue scale (VAS). In addition, patients, operator satisfaction and duration of procedure were assessed. RESULTS: There were no differences in the demographic data of the groups. Pain scores during biopsy and ECC were significantly lower in Group L than in Group C (p < 0.001). The duration of the procedure was significantly shorter in Group L than in Group C (5.00 ± 0.78 vs 6.12 ± 1.16, respectively; p < 0.001). Patient and operator satisfaction were significantly higher in Group L than in Group C (p < 0.001). CONCLUSIONS: Intravenous lidocaine administration can be used as an alternative approach to reduce pain and increase operator and patient satisfaction during colposcopy-directed biopsy and ECC procedures in office settings.
目的:近年来,利多卡因输注在麻醉学实践中越来越广泛地用于长手术期间的疼痛管理。然而,只有少数研究报告了利多卡因的静脉内短期干预。本研究旨在调查静脉内使用利多卡因在阴道镜宫颈活检和宫颈内膜刮除术(ECC)期间疼痛管理中的效果。
材料和方法:本随机双盲研究纳入了年龄在 18 至 65 岁之间、细胞学异常或 HPV 阳性的患者。利多卡因组(L 组,n = 30)在手术前 3 分钟至 30 分钟内静脉注射 50mg 右旋酮洛芬+1.5mg/kg 利多卡因,共 10mL 生理盐水。对照组(C 组,n = 30)在手术前 3 分钟内静脉注射 50mg 右旋酮洛芬,共 10mL 生理盐水。在手术过程中,使用视觉模拟评分(VAS)评估疼痛评分。此外,还评估了患者、操作人员的满意度和手术持续时间。
结果:两组患者的人口统计学数据无差异。L 组活检和 ECC 期间的疼痛评分明显低于 C 组(p < 0.001)。L 组的手术持续时间明显短于 C 组(分别为 5.00 ± 0.78 与 6.12 ± 1.16;p < 0.001)。L 组患者和操作人员的满意度明显高于 C 组(p < 0.001)。
结论:在局麻下进行阴道镜宫颈活检和 ECC 时,静脉内给予利多卡因可作为一种替代方法,以减轻疼痛并提高操作人员和患者的满意度。
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