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效果观察

Effect of Intrauterine Lidocaine and Rectal Naproxen Suppository on Pain Relief in First-trimester Surgical Abortion

目的研究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,按宫腔内注射6 ml 2%利多卡因或生理盐水,及经直肠给予萘普生栓或安慰剂栓随机分为4组。以视觉模拟评分法(visual analogue scale,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。结果与仅给予生理盐水宫腔内注射及安慰剂栓的对照组相比,3个实验组术中、术后VAS评分均显著下降,术后即刻VAS评分3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。

Objective To investigate the analgesic efficacy of intrauterine lidocaine and rectal naproxen suppository in patients undergoing first-trimester surgical abortion. Methods A randomized,double-blind,placebo-controlled trial was conducted on 224 patients undergoing surgical abortion on 6 to 12 weeks of pregnancy.Subjects were randomly assigned into 4 groups receiving intrauterine injection of either 6ml 2% lidocaine or normal saline and rectal suppositories of either 0.4g naproxen or placebo.Pain scores were evaluated during cervical dilation,immediately after procedure,30 and 60 minutes after procedure using visual analogue scale（VAS）. Results The mean pain scores in all 3 experiment groups were significantly reducted compared with the control group treated by placebo and saline（P0.001）.No significant difference was observed in the mean pain scores immediately after the procedure among 3 experiment groups.The pain score of the group treated by naproxen was higher during cervical dilation and lower after the procedure than that of the group treated by lidocaine.The pain score was lowest and there was no artificial abortion syndrome occurrence in the group treated by combined naproxen and lidocaine. Conclusion Intrauterine injection of 6ml 2% lidocaine appears effective in pain relieving in artificial abortion without any adverse reactions.The combined utilization of naproxen suppository can further reduce the post-abortion pain.