RESUMEN
Objective:To investigate the safety and efficacy of ultrasound-guided transversus abdominis plane (TAP) combined with paracervical block in percutaneous microwave ablation(PMWA) of uterine fibroids.Methods:Twenty-four patients with uterine fibroids who underwent PMWA after ultrasound-guided TAP combined with paracervical block in Sichuan Cancer Hospital from October 2021 to January 2022 were retrospectively analyzed. The success rate and adverse reactions of TAP combined with paracervical block were recorded, and the types and doses of rescue analgesics used during and after operation were recorded. The pain degree of patients was recorded by NRS(numeric rating scales) during and 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 12 hours and 24 hours after operation, and the satisfaction of patients was recorded.Results:The success rate of TAP combined with paracervical block was 100%, and there were no adverse reactions during and after operation. During the operation, 5 patients(20.83%) had mild pain, which was tolerable and did not need intervention, 4 patients(16.67%) presented with moderate pain, and the NRS scores were 4, 4, 5 and 6 respectively, the symptoms were relieved after rescue analgesia. All patients completed one ablation, no ablation failure or secondary ablation. Some patients had mild pain after operation, which could be tolerated without intervention, and all were relieved naturally within 6 hours. All patients returned home on the day of ablation and were 100% satisfied with the analgesic effect.Conclusions:Ultrasound-guided TAP combined with paracervical block in PMWA of uterine fibroids is safe and effective, which is worthy of clinical promotion.
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OBJECTIVE: In Korea, approximately 600 thousand artificial abortions are done officially during the course of a year, and dilatation and curettage is commonly used as a method for selective abortion. In addition, because of the increasing use of hormone replacement therapy for treating postmenopausal syndrome and for the diagnostic purposes for postmenopausal bleeding, the importance of dilatation and curettage is emphasized more and more. Our objective was to verify the effects of delayed time between paracervical block and the procedure of dilatation and curettage on pain and patient satisfaction. METHODS: 92 women who underwent dilatation and curettage were picked and divided into 2 groups randomly. In group A there was no transit delay time between paracervical block and the procedure, and in group B, there was 5 minutes delay time. We used the VAS (Visual Analogue Scale) to measure numerical value of pain and patient satisfaction during uterine cervical dilatation, the actual procedure of curettage, and 30-45 minutes after the procedure. RESULTS: There was no statistically meaningful difference on the pain value and patient satisfaction between group A and group B measured during uterine cervix dilatation, curettage, and 30-45 minutes after the procedure. CONCLUSION: The transit delay time between paracervial anesthesia and dilatation and curettage had no specific effects on the pain or patient satisfaction of the procedure. Therefore, the main role of paracervical anesthesia is not to block the peripheral nerve, but instead to dilatate the tissue mechanically.
Asunto(s)
Femenino , Humanos , Embarazo , Aborto Eugénico , Anestesia , Anestesia Obstétrica , Cuello del Útero , Legrado , Dilatación y Legrado Uterino , Dilatación , Hemorragia , Terapia de Reemplazo de Hormonas , Corea (Geográfico) , Primer Periodo del Trabajo de Parto , Satisfacción del Paciente , Nervios PeriféricosRESUMEN
The effect of paracervical block in 30 nulliparas undergoing artificial abortion were com- pared. An electric stimulation was given to the cervix five minutes before anesthesia, three and twenty minutes after anesthesia. The value of stimulant voltages was recorded when patients felt pain. The pain threshold increased from 63.63 ? 18.26 volts of preanesthesia to 110.80? 17.27 volts of 3 minutes after paracervical block (P