利多卡因宫腔内注射及复方萘普生栓用于人工流产镇痛的随机对照研究

目的探讨利多卡因宫腔内注射与经直肠给予萘普生栓对早孕人工流产患者的镇痛效果。方法 224例孕6～12周人工流产患者,随机分为四组,Ⅰ组接受利多卡因宫腔内注射,同时经直肠给予萘普生栓;Ⅱ组接受利多卡因宫腔内注射以及安慰剂栓;Ⅲ组为生理盐水宫腔内注射,同时经直肠予以萘普生栓;Ⅳ组仅给予生理盐水宫腔内注射及安慰剂栓。以视觉模拟评分法(VAS)观察患者术中扩张宫颈时、术后即刻、术后30 min及术后60 min的疼痛程度。结果Ⅰ、Ⅱ、Ⅲ组与Ⅳ组相比,无论术中术后VAS评分均有显著下降,术后即刻VAS评分Ⅰ、Ⅱ、Ⅲ组无差别,单独使用萘普生的实验组扩宫时VAS评分高于单独使用利多卡因组,但术后VAS评分则相反,两者联合使用时术中术后VAS评分均为最低,且没有人流综合征发生。结论使用2%利多卡因6ml宫腔注射用于人工流产可以达到满意的镇痛效果,无副作用,加用萘普生栓可以进一步减轻术后的疼痛。

A randomized controlled study on of intrauterine Lidocaine and rectal Naproxen suppository for pain relief in surgical abortion

Objective To investigate the analgesic efficacy of intrauterine Lidocaine and rectal Naproxen suppository in patients undergoing first-trimester surgical abortion.Methods 224 subjects were randomly assigned into 4 groups.Group Ⅰ received intrauterine Lidocaine and rectal Naproxen suppository;Group Ⅱ received intrauterine Lidocaine and placebo suppositories;Group Ⅲ received saline and rectal Naproxen suppositories;Group Ⅳreceived saline and placebo suppositories.And the main outcome measure was the intensity of pain measured by visual analog scale(VAS).Pain scoring was performed during cervical dilation,immediately after procedure,30 and 60 minutes post procedure.Results Compared with group Ⅳ,the intraoperative and postoperative VAS scores in Ⅰ,Ⅱ,Ⅲ groups were decreased significantly,no difference was found in VAS scores of immediately after procedure among theⅠ,Ⅱ,Ⅲ groups.Compared to the Lidocaine-only group,VAS score with dilation was higher but postoperatively VAS score was decreased in the Naproxen-only group.The intraoperative and postoperative VAS scores of conjunctive use of Lidocaine and Naproxen were lowest without the induced abortion syndrome.Conclusion 6ml intrauterine 2% Lidocaine in surgical abortion is particularly effective in relieving abortion related pain with no significant adverse reactions.Moreover,a combination of Naproxen suppository works better in further reduction of post abortion pain.