腰麻、宫颈旁阻滞、全身麻醉用于诊断性宫腔镜检查术镇痛镇静效果比较  

Comparison of the analgesic and sedative effect of the lumbar anesthesia,the paracervical block and the general anesthesia used in the diagnostic hysteroscopy examination

作　　者：孙文龙 叶月利 罗苹 宋燕 陈爱芳 SUN Wenlong;YE Yueli;LUO Ping;SONG Yan;CHEN Aifang(Quzhou Hospital of Traditional Chinese Medicine,Quzhou,Zhejiang Province,324000)

机构地区：[1]浙江省衢州市中医医院,324000

出　　处：《中国计划生育学杂志》2024年第10期2283-2287,2292,共6页Chinese Journal of Family Planning

摘　　要：目的:比较腰麻、宫颈旁阻滞和全身麻醉对诊断性宫腔镜检查术患者镇痛镇静效果。方法:选取2022年3月-2024年3月在本院进行诊断性宫腔镜检查的患者共207例,按随机数表分为腰麻、宫颈旁阻滞和全身麻醉3种方式组各69例,分析比较检查术中疼痛、恶心和呕吐以及镇痛镇静效果。结果:单因素ANOVA方差分析,3组手术时间、麻醉时间、恢复时间有差异,且事后两两比较,腰麻组手术时间最短,宫颈旁阻滞术组麻醉时间与恢复时间最短(均P<0.001)。麻醉期间,3组收缩压、舒张压、镇静评分有差异(P<0.001);腰麻组在麻醉期间与检查期间疼痛(VAS)得分(0.90±0.30分、0.38±0.49分)低于宫颈旁阻滞术组(1.78±1.90分、1.59±1.18分)(P<0.001)。恢复期间,腰麻组无中度与重度疼痛患者、宫颈旁阻滞术组无重度疼痛患者、全身麻醉处于高度疼痛程度人数占比(24.6%)最多(均P<0.001),3组恶心呕吐、眩晕发占比无差异(P>0.05)。恢复期间全身麻醉组处于镇静过度(29.0%)、需镇静人数占比(50.7%)大于另外两组(P<0.001)。结论:在诊断性宫腔镜检查术中,麻醉过程与检查过程中,宫颈旁阻滞组疼痛大于腰麻组;恢复过程中,全身麻醉组疼痛大于另外两组;3组恶心呕吐反应差别不大;麻醉期间腰麻组与宫颈旁阻滞术组镇静水平均低于检查期间;全身麻醉组在恢复期间镇静水平偏高,镇静需求最大。Objective:To compare the analgesic and sedative effect of the lumbar anesthesia,the paracervical block and the general anesthesia used in the diagnostic hysteroscopy examination.Methods:A total of 207 patients who wanted diagnostic hysteroscopy examination were selected and were randomly divided into three methods(69 cases in each group)from March 2022 to March 2024.The patients in group A,group B and group C during diagnostic hysteroscopy examination were given lumbar anesthesia,paracervical anesthesia and general anesthesia,respectively.The rates of pain,nausea and vomiting,and the analgesic and sedative effect of the patients during the diagnostic hysteroscopy ex-amination were analyzed and compared among the three groups.Results:One-way ANOVA variance analysis showed that there were significant differences in the surgical time,the anesthesia time and the recovery time of the patients a-mong the three groups.The operation time of the patients in group A was the shortest,and the anesthesia time and the recovery time of the patients in group B were the shortest(all P<0.001).During anesthesia,there were significant differences in the values of systolic blood pressure and diastolic blood pressure,and the sedation score of the patients a-mong the three groups(P<0.001).The VAS scores of the patients in group A during anesthesia and during examina-tion(0.90±0.30 points and 0.38±0.49 points)were significantly lower than those(1.78±1.90 points and 1.59±1.18 points)of the patients in group B(P<0.001).During the period of recovery,there was no patient with moderate to severe pain in group A,and there was no patient with severe pain in group B.The patients with severe pain in group C accounted to 24.6%,which was the most(all P<0.001).There were no significant differences in the rates of nausea and vomiting,and dizziness of the patients among three groups(P>0.05).During the recovery period,there were.29.0%patients with severe sedative,and the proportion(50.7%)of the patients needed sedative in group C was signif-icantl

关 键 词：宫腔镜检查术 腰麻 宫颈旁阻滞 全身麻醉 疼痛 恶心和呕吐 镇痛效果 

分 类 号：R614[医药卫生—麻醉学] R713[医药卫生—外科学]