同杜叮在IVF-ET取卵术镇痛中的应用

Application of diclofenac for oocyte retrieval analgesia in IVF-ET cycles

目的探讨同杜叮在辅助生殖取卵术中应用的效果。方法分析2010年11月-2011年4月,于本中心行试管婴儿取卵术的1 176例患者资料,按照镇痛药物使用情况,随机分为哌替啶组(573例)和同杜叮组(603例)。收集围术期血压、脉搏、血氧饱和度等数据,记录术中疼痛程度及恶心、呕吐、头晕等不良反应及严重不良反应资料。另外,进行两组间IVF-ET指标比较。结果哌替啶组术后血压及脉搏较同杜叮组低(P均<0.001),其余生命体征数据差别不明显(P均>0.05)。同杜叮组一般不良反应较少(P均<0.05)。两组间疼痛程度差异无统计学意义(P=0.304),IVF-ET指标差异亦无统计学意义(P均>0.05)。同杜叮组术后发生了3例腹腔大出血伴休克。结论在辅助生殖取卵术中使用同杜叮镇痛效果良好,不影响体外受精-胚胎移植结局,但是需要密切注意预防腹腔大出血的发生。

Objective To study the effect of diclofenac on oocyte retrieval of assisted reproduction.Methods The materials of 1 176 cases of oocyte retrieval in IVF cycles in our center from November 2010 to April 2011 was analyzed.According to the analgesic drug use,the patients were randomly divided into pethidine group（573 cases）and diclofenac group（603 cases）.Data of perioperative blood pressure,pulse,blood oxygen saturation,etc was collected.The intraoperative pain degree and adverse reactions,which including nausea,vomiting,dizziness and serious adverse reactions were recorded.The IVF-ET results were also compared.Results The post-operation pressure and pulse of pethidine group were lower than those of diclofenac group（P〈0.001）.No significant significane was found in the rest vital signs of the two groups（P〈0.05）.Cases of general body adverse reactions in diclofenac group were relative less than those of pethidine group（P〈0.05）.Difference in pain degree between the two groups was not significant（P=0.304）.No significant difference was found in IVF-ET indicators between the two groups（P〈0.05）.There were 3 cases of serious postoperative abdominal bleeding with shock in diclofenac group.Conclusion Using diclofenac in the analgesic of oocyte retrieval in assisted reproductive has a quite good effect,and it has no influence on the results of IVF-ET.Howerer,close attention should be paid to serious abdominal bleeding.