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异丙酚静脉麻醉联合针刺镇痛对无痛人流术中镇痛效果的影响。

Effect of Propofol Intravenous Anesthesia Combined with Press-Needle Therapy on Analgesic Effect during Painless Abortion.

机构信息

Department of Anesthesiology, The Affiliated Lianyungang Oriental Hospital of Xuzhou Medical University, Lianyungang, Jiangsu 222042, China.

Center for Clinical Research and Translational Medicine, The Affiliated Lianyungang Oriental Hospital of Kangda College of Nanjing Medical University, Lianyungang, Jiangsu 222042, China.

出版信息

Comput Math Methods Med. 2022 Aug 8;2022:6543211. doi: 10.1155/2022/6543211. eCollection 2022.

Abstract

OBJECTIVE

To discover the effect of propofol intravenous anesthesia along with press-needle therapy on analgesic effect during painless abortion.

METHODS

A total of 128 cases who experienced painless abortion in our hospital from January 2019 to August 2021 were recruited as the research subjects. They were categorized into control and observation groups through the haphazard number table approach, with 64 patients in each group. Propofol intravenous anesthesia was given to the control group, and the observation group was given combined anesthesia with press-needle on this basis. Ramsay score, hemodynamic indexes, operation-related indexes, and postoperative recovery were studied between the two groups before anesthesia (T0), at the time of uterine aspiration (T1), promptly following the operation (T2), and at the recovery time of directional force (T3). The stress state and the level of pain mediators in the two groups of sufferers were observed at each time period, and the visual analogue scale (VAS) was employed to assess the degree of postoperative uterine contraction pain.

RESULTS

Ramsay score at T1 and T2 time points in observation group was lesser than that in control group ( < 0.05). There existed no meaningful discrepancies in operation time and recovery time between both groups ( > 0.05). The total dosage of propofol in the observation group was lesser compared to that in the control group, and the recovery time of directional force was much shorter compared to that in the control group ( < 0.05). There existed no meaningful discrepancies in perioperative diastolic blood pressure (DBP), systolic blood pressure (SBP), and heart rate (HR) between both groups ( > 0.05). The levels of norepinephrine (NE), cortisol (Cor), glucose (GLU) and substance P (SP), prostaglandin E2 (PGE2), and 5-hydroxytryptophan (5-HT) in the observation group were lesser than those in the control group immediately after surgery and 24 hours following the operation ( < 0.05). There existed no meaningful discrepancies in vaginal bleeding time, endometrial thickness 3 weeks after operation, and time to start menstruating between both groups ( > 0.05). The score of VAS for the observation group was lesser than that of the control group at 10 min and 30 min after operation ( < 0.05). There existed no substantial discrepancy in the incidence of negative reactions between both groups ( > 0.05).

CONCLUSION

Propofol intravenous anesthesia combined with press-needle therapy can ameliorate the analgesic impacts during painless abortion, reduce postoperative uterine contraction pain, inhibit the release of postoperative pain mediators, and improve the stress state of the body.

摘要

目的

探讨异丙酚静脉麻醉联合针刺镇痛对无痛人流术患者镇痛效果的影响。

方法

选取 2019 年 1 月至 2021 年 8 月在我院行无痛人流术的 128 例患者作为研究对象,采用随机数字表法将其分为对照组和观察组,每组 64 例。对照组给予异丙酚静脉麻醉,观察组在此基础上联合针刺麻醉。观察两组患者麻醉前(T0)、子宫吸引时(T1)、术毕即刻(T2)、定向力恢复时(T3)的 Ramsay 评分、血流动力学指标、手术相关指标及术后恢复情况,观察两组患者各时间点应激状态和疼痛介质水平,采用视觉模拟评分法(VAS)评估术后子宫收缩痛程度。

结果

观察组 T1、T2 时 Ramsay 评分均低于对照组(<0.05)。两组手术时间、定向力恢复时间比较,差异均无统计学意义(>0.05)。观察组异丙酚总用量少于对照组,定向力恢复时间短于对照组(<0.05)。两组患者围术期舒张压(DBP)、收缩压(SBP)、心率(HR)比较,差异均无统计学意义(>0.05)。观察组患者术后即刻及术后 24 h 时去甲肾上腺素(NE)、皮质醇(Cor)、血糖(GLU)、P 物质(SP)、前列腺素 E2(PGE2)、5-羟色胺(5-HT)水平均低于对照组(<0.05)。两组患者术后 3 周时阴道出血时间、子宫内膜厚度、月经恢复时间比较,差异均无统计学意义(>0.05)。观察组术后 10、30 min 时 VAS 评分均低于对照组(<0.05)。两组患者不良反应发生率比较,差异无统计学意义(>0.05)。

结论

异丙酚静脉麻醉联合针刺镇痛可增强无痛人流术的镇痛效果,减轻术后子宫收缩痛,抑制术后疼痛介质释放,改善机体应激状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5def/9377957/b2612075b513/CMMM2022-6543211.001.jpg

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