取卵术中患者疼痛程度及不同镇痛药物的疗效研究

Evaluation of the pain level of patients during oocyte retrieval and the efficacy of different analgesic drugs

目的 评估经阴道穿刺取卵术中患者的疼痛感,比较不同镇痛药物的疗效,为经阴道穿刺取卵术镇痛治疗中的药物应用提供参考。方法 采取方便抽样法,选取本院生殖中心2021年4—9月269名拟行经阴道穿刺取卵术的患者作为研究对象。采用自制问卷对研究对象进行问卷调查,并对所得数据进行统计分析。结果 176名研究对象表示取卵术中感受到的疼痛为轻度疼痛甚至无痛,93名研究对象表示取卵术中感受到的疼痛为中重度疼痛。不同年龄段研究对象的取卵术中疼痛程度比较,差异有统计学意义(P<0.05)。取卵术中未使用镇痛药物的研究对象在术中感受到的疼痛等级为无痛及轻度疼痛(控制疼痛效果理想)的人数占比为64.10%,而使用了杜冷丁、地佐辛、双氯芬酸钠和布洛芬的研究对象在取卵术中感受到的疼痛等级为无痛及轻度疼痛的人数占比分别为68.75%、57.69%、52.00%和79.69%。以上5组研究对象控制疼痛效果理想率比较,差异有统计学意义(P<0.05),多重比较结果显示,使用布洛芬组研究对象与使用双氯芬酸钠组研究对象控制疼痛效果理想率比较,差异有统计学意义(P<0.005)。取卵术中未使用镇痛药物的研究对象术中及术后不良反应发生率为87.18%,而使用了杜冷丁、地佐辛、双氯芬酸钠和布洛芬的研究对象术中及术后不良反应发生率分别为95.31%、94.23%、82.00%和67.19%。以上5组研究对象术中及术后不良反应发生率比较,差异有统计学意义(P<0.05),多重比较结果显示,使用布洛芬组研究对象与使用杜冷丁组研究对象、使用地佐辛组研究对象术中及术后不良反应发生率比较,差异均有统计学意义(P<0.005)。结论 取卵术中大部分患者均有不同程度的疼痛不适感。布洛芬相较其他药物在经阴道穿刺取卵术中的镇痛效果更好,不良反应发生率较低,值得推广。

Objective This paper aims to evaluate the pain level of patients undergoing transvaginal oocyte retrieval and compare the efficacy of different analgesic drugs to provide evidence for the application of analgesic drugs in transvaginal oocyte retrieval.Methods A total of 269 patients scheduled for transvaginal oocyte retrieval from April to September 2021 in the Reproductive Center of our hospital were selected as the participants by convenient sampling method.Participants were investigated using a self-made questionnaire.Statistical analyses were performed on the obtained data.Results Overall,176 participants stated that the pain felt during oocyte retrieval was mild or even painless,and 93 participants stated that the pain felt during oocyte retrieval was moderate to severe.A significant difference was found in the degree of pain during oocyte retrieval between participants of different ages(P<0.05).The proportion of participants who did not use analgesic drugs during oocyte retrieval who felt painless and mild pain during surgery(ideal pain control)was 64.10%,while the proportion of participants who used meperidine,dezocine,diclofenac sodium,and ibuprofen who felt painless and mild pain during oocyte retrieval was 68.75%,57.69%,52.00%,and 79.69%,respectively.There were significant differences in the ideal rate of pain control among the above five groups(P<0.05).Multiple comparison results showed that significant differences were found in the ideal rate of pain control between the ibuprofen group and the diclofenac sodium group(P<0.005).The incidence of intraoperative and postoperative adverse reactions was 87.18%in participants who did not use analgesic drugs during oocyte retrieval,while 95.31%,94.23%,82.00%,and 67.19%in those who used meperidine,dezocine,diclofenac sodium,and ibuprofen,respectively.The differences in the incidence rate of intraoperative and postoperative adverse reactions among the above five groups were statistically significant(P<0.05).The multiple comparison results showed significant differences in the incidence rate of intraoperative and postoperative adverse reactions between the participants in the ibuprofen group and those in the meperidine and dezocine groups(P<0.005).Conclusion Most patients have different degrees of pain and discomfort during oocyte retrieval.Ibuprofen has better analgesic efficacy and a lower incidence of adverse reactions than other drugs in transvaginal oocyte retrieval,justifying a wider application.