不同麻醉方式及给药途径对人工流产术镇痛效果影响的研究

目的探讨静脉缓慢推注丙泊酚联合阴道后穹窿放置米索前列醇、笑气吸入联合阴道后穹窿放置米索前列醇、利多卡因联合阿托品宫颈旁局部阻滞麻醉三种不同的麻醉方式及给药途径在人工流产术中的镇痛效果。方法随机选择在曹妃甸区妇幼保健院妇产科门诊就诊的360例早孕自愿接受人工流产术者，将这360例孕妇随机分成四组，每组90例。分别为A组丙泊酚联合米索前列醇组，B组笑气联合米索前列醇组，C组利多卡因联合阿托品组，D组对照不采取任何干预措施，观察各组的镇痛效果。结果A、B、C三组镇痛效果、宫颈松弛程度、人工流产综合征的发生率，结果差异有统计学意义（P〈0．05），A组静脉缓慢推注丙泊酚联合阴道后穹窿放置米索前列醇效果最佳。结论静脉缓慢椎注丙泊酚联合阴道后穹窿放置米索前列醇应用于人工流产术镇痛效果最佳；笑气吸入联合阴道放置米索前列醇用于人流工流术产效果次之；利多卡因联合阿托品宫颈旁局部阻滞麻醉用于人工流产术效果一般。

STUDY ON ANALGESIA EFFECTS OF DIFFERENT ANESTHESIA AND ROUTE OF MEDICATION IN ARTIFICAL ABORTION

Objective To investigate the effects of the three different anesthesia methods and routes of medication in artificial abortion, the three methods were respectively intravenous injection of propofol combined with misoprostol in vaginal fornix, nitrous oxide inhalation combined with misoprostol in vaginal fornix and cervical local anesthesia of lidocaine combined with atropine. Methods A sample of 360 cases of early pregnancy who visited obstetrics and gynecology clinic of Caofeidian Area Maternal and Child Health Hospital between March, 2011 and June, 2013 and who were voluntary to accept artificial abortion were selected randomly. And all the cases were randomly divided into four groups, each group of 90 people. Group A, B, C were respectively given the propofol combined with misoprostol, nitrous oxide combined with misoprostol and lidocaine and atropine, Group D had no any intervention. Then the analgesic effect in each grou was observed. Results The incidences of the analgesic effect, the degree of cervical relaxation and the artificial abortion syndrome in the three groups （Group A , B C） had significant difference （P〈0.05）. The effect of group A with intravenous injection of propofol combined with misoprostol vaginal fornix was the best. Conclusion Intravenous injection of propofol combined with misoprostol in vaginal fornix used in artificial abortion has the best analgesia effect, nitrous oxide inhalation combined with misoprostol for artificial abortion takes the second place, cervical local anesthesia of lidocaine combined with atropine in artificial abortion has a general effect.