卡诺某三级医院不孕妇女子宫输卵管造影期间,宫颈内利多卡因与肌内双氯芬酸缓解疼痛的效果:一项随机对照试验

A. Avidime, Sulaiman Daneji Muhammad, Ibrahim S Adamu
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引用次数: 1

摘要

背景:子宫输卵管造影(HSG)是子宫和输卵管的放射学评估,主要用于评估不孕症。子宫输卵管造影在手术过程中或手术后会引起不适或疼痛,高达72%的女性抱怨这项检查有明显的不适。这种疼痛会阻碍患者的配合,从而限制了手术的有效性,也限制了他们做其他类似诊断研究的意愿。它也可以导致偶然的输卵管阻塞引起角痉挛。目的:比较1%利多卡因颈内阻滞和双氯芬酸75mg肌注对子宫输卵管造影时疼痛感觉的影响。方法:研究时间为2016年9月至2017年1月。140名不孕症妇女被随机招募并被分配到两个研究组进行子宫输卵管造影。研究小组A的女性在手术前30分钟给予1%利多卡因宫颈内阻滞,而研究小组B的女性在手术前30分钟给予肌肉注射双氯芬酸钠75mg。采用视觉模拟评分法评估HSG特定阶段的疼痛程度。使用社会科学统计软件包(SPSS) 16.0版本对数据进行分析。所得数据以表格形式呈现。分类资料采用卡方检验和fisher精确校正,连续资料采用学生t检验;显著性水平(p值)设为p< 0.05。结果:两组患者基线特征差异无统计学意义;但在一些妇科特征上有统计学上的显著差异,包括以前的阴道分娩和以前的流产。A组和b组的平均视觉模拟评分(VAS)分别为4.26±1.62和6.37±1.62 (t = -7.726, p值<0.001)、6.14±1.85和7.37±2.23 (t = -3.543 p值0.001)。结论:利多卡因宫颈内阻滞治疗不孕症输卵管造影时VAS疼痛评分显著降低。
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The Effect of Intracervical Lidocaine Versus Intramuscular Diclofenac for Pain Relief During Hysterosalpingography Among Infertile Women in A Tertiary Hospital in Kano: A Randomised Controlled Trial
Background: Hysterosalpingography (HSG) is the radiographic evaluation of the uterus and fallopian tubes and is used predominantly in the evaluation of infertility. HSG can cause discomfort or pain during or after the procedure, up to 72 % of women complain of significant discomfort with this test. This pain can hinder patient’s co-operation, therefore limiting the usefulness of the procedure, and willingness to do other similar diagnostic studies. It can also result in fortuitous tubal blockade by provoking cornual spasms. Objectives: To compare the effect of intracervical block with 1% lidocaine and intramuscular diclofenac 75mg in decreasing pain perception during hysterosalpingography. Methods: The study was carried out between September 2016 and January 2017. One hundred and forty women with infertility referred for hysterosalpingography were randomly recruited and assigned to two study groups. Women in the study group A were given an intracervical block with 1% lidocaine while women in the Study Group B were given intramuscular diclofenac sodium 75mg 30 minutes before the procedure. Pain levels during specified stages of HSG were assessed using visual analogue score. The statistical package for social sciences (SPSS) version 16.0 was used to analyze the data. The data obtained were presented in tables. Categorical data were analyzed using chi-squared test and Fishers exact correction, continuous data were analyzed using student t-test; level of significance (p-value) was set at p< 0.05. Results: There was no statistically significant difference in the two study groups in their baseline characteristics; but there were statistically significant differences in some gynaecological characteristics that include previous vaginal delivery and previous pregnancy loss. The two most painful steps of the procedure were during grasping of the cervix and uterine distension with contrast medium mean visual analogue score (VAS) of 4.26±1.62 and 6.37±1.62 (t = -7.726, p-value <0.001), 6.14±1.85 and 7.37±2.23 (t = -3.543 p-value 0.001) respectively in groups A and B. Conclusion: There was significant reduction in VAS pain scores with intracervical block with lidocaine when performing HSG for infertility.
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