两种方法用于人工流产手术镇痛的对比研究

目的 从妇科神经解剖学角度入手,比较骶前孔阻滞和骶管阻滞麻醉用于人工流产镇痛的效果. 方法 选取接受人工流产术者263例,随机分为骶前孔阻滞组(95例)、骶管阻滞组(90例)和无镇痛组(78例)3组.监测各组麻醉范围、双下肢皮温、肛温、血压、脉搏、呼吸、心率、临床效果及手术中视觉摸拟评分(VAS)变化. 结果 骶前孔阻滞组阻滞后15 min麻醉范围及皮温变化涉及臀中神经、臀下神经、阴部神经、股后皮神经、坐骨神经分布区,与阻滞前比较,双下肢皮温升高,差异有统计学意义(P<0.01);手术前后血压、脉搏、呼吸、心率无显著变化,术中及术后30 min骶前孔阻滞组疼痛评分显著低于骶管阻滞组及无镇痛组(P<0.01). 结论 骶前孔阻滞操作简便、安全,效果肯定,可作为人工流产镇痛的新途径.

Clinical study of the effect of two kinds of analgisia ways on induced abortion

Objective To compare the effect of artianterior sacralia foramina block and sacral block on induced abortion.Mathods 263 women for induced abortion were randomly devided into three groups:the group for anteriora sacralia foramina block (n=95),the group for sacral block (n=90),the control group (n=78).Parameters before and after abortion measured include anesthesia area,skin of both legs and anus tempreture,blood pressure,pulse rate,resperatory rate,heart rate,clinical effect and VAS score.Results At 15 minutes after the anteriora sacralia foramina blocking,the anesthesia area involved distribution of medii clunium nerve,glacens nerve,puden-dus nerve,posterior femoris cutaneus nerve,ischiadicus nerve.The skin temperatures of both legs increased significantly (P＜0.01).Blood pressure,pulse rate,resperatory rate,and heart rate didn't vary markedly.The analgisia effect of anteriora sacralia foramina block was superior to sacral block.Conclusion The anteriora sacralia foramina block is simple,safe,effective,practical and can become a new approach for analgisia in induced abortion.