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镇静术前用药在小切口开腹女性绝育术中的价值:两种局部麻醉方案的前瞻性研究

Value of sedative premedication in female sterilization via minilaparotomy: a prospective study of two local anaesthesia regimen.

作者信息

Ruminjo J K, Achwal I, Maina B

机构信息

Family Health International, Research Triangle Park, NC 27709, USA.

出版信息

East Afr Med J. 1995 Oct;72(10):678-83.

PMID:8904053
Abstract

A prospective study of two local anaesthesia regimen for female sterilization is presented. A total of 1,077 female clients were sterilized via minilaparotomy under local anaesthesia (ML/LA) as outpatients. The clients underwent pre-operative screening and received pre-operative and continuing counselling. The first 257 of these clients were sedated with an intramuscular injection of pethidine after atropine premedication (pre-sedated group). The other clients (non-sedated group) were premedicated with atropine alone, without sedation. For the pre-sedated group, the mean volume of one percent lignocaine used was 18.3 (S.D. 2.2) ml, the mean length of surgical incision was 2.8 (S.D. 0.5) cm, and the mean duration of surgical was 15.8 (S.D. 5.3) minutes; 8.2% of these clients reported that they felt much pain. In comparison, 7.7% of the non-sedated group clients reported much pain following a mean of 17.7 ml of one percent lignocaine (S.D. 2.7) through an incision of mean length 2.5 (S.D. 0.5) cm for surgery lasting a mean of 14.5 (S.D. 4.5) minutes. Clients who were pre-medicated with pethidine were more likely to have multiple post-operative complaints, especially dizziness, faintness, headache, nausea and vomiting. This study found no significant difference in the clinical performance of female sterilization by minilaparotomy, duration of operation, length of incision, amount of local anaesthesia required or perception of pain between clients who were premedicated with intramuscular pethidine and those who were not.

摘要

本文介绍了一项关于两种女性绝育局部麻醉方案的前瞻性研究。共有1077名女性患者在局部麻醉下通过小切口剖腹术(ML/LA)进行绝育手术,作为门诊患者。患者接受了术前筛查,并接受了术前和持续的咨询。其中前257名患者在阿托品预处理后通过肌肉注射哌替啶进行镇静(预镇静组)。其他患者(非镇静组)仅用阿托品预处理,未进行镇静。对于预镇静组,使用的1%利多卡因平均剂量为18.3(标准差2.2)毫升,手术切口平均长度为2.8(标准差0.5)厘米,手术平均持续时间为15.8(标准差5.3)分钟;8.2%的患者表示感到非常疼痛。相比之下,非镇静组7.7%的患者在平均使用17.7毫升1%利多卡因(标准差2.7)、通过平均长度为2.5(标准差0.5)厘米的切口进行平均持续时间为14.5(标准差4.5)分钟的手术后表示非常疼痛。接受哌替啶预处理的患者术后更易出现多种不适,尤其是头晕、乏力、头痛、恶心和呕吐。本研究发现,在小切口剖腹术进行女性绝育的临床表现、手术持续时间、切口长度、所需局部麻醉量或疼痛感受方面,肌肉注射哌替啶预处理的患者与未进行预处理的患者之间无显著差异。

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