对于妊娠前三个月的堕胎手术疼痛控制:随机对照试验的系统评价。

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雷纳RM,詹森JT,尼科尔斯医学博士Edelman AB

对于妊娠前三个月的堕胎手术疼痛控制:随机对照试验的系统评价。

避孕措施。2010年5月,81 (5):372 - 88。doi: 10.1016 / j.contraception.2009.12.008。Epub 2010年1月27日。

PubMed ID

20399943 (在PubMed

]

文摘

背景:对于妊娠前三个月的堕胎尤其是宫颈扩张和吸入愿望与疼痛,尽管疼痛控制的各种方法。研究设计:Cochrane审查指南后,我们系统地寻找并回顾了随机对照试验比较疼痛控制方法对于妊娠前三个月流产手术不到14周胎龄使用电动或手动抽吸愿望。必威国际app结果包括内部和术后疼痛,副作用,恢复措施和满意度。结果:我们与5131名参与者包括40试验。由于异质性,我们将研究分为七组:局部麻醉:数据不足以表现出明显的一个好处paracervical块比没有印刷电路板(PCB)。报道平均疼痛评分(10分制)在扩张和愿望是改善与碳酸利多卡因(加权平均差(大规模杀伤性武器),-0.80;95%可信区间(CI), -0.89 - -0.71;大规模杀伤性武器,-0.96;95%可信区间,-1.67至-0.25),深注入(大规模杀伤性武器,-1.64;95%可信区间,-3.21 - -0.08; WMD, 1.00; 95% CI, 1.09 to 0.91), and with adding a 4% intrauterine lidocaine infusion (WMD, -2.0; 95% CI, -3.29 to -0.71; WMD, -2.8; 95% CI, -3.95 to -1.65). PCB with premedication: Ibuprofen and naproxen resulted in small reduction of intra- and postoperative pain. Conscious sedation: The addition of conscious intravenous sedation using diazepam and fentanyl to PCB decreased procedural pain. General anesthesia: Conscious sedation increased intraoperative but decreased postoperative pain compared to general anesthesia (GA) [Peto odds ratio (Peto OR) 14.77 (95%, CI 4.91-44.38) and Peto OR 7.47 (95% CI, 2.2-25.36) for dilation and aspiration, respectively, and WMD -1.00 (95% CI, -1.77 to -0.23) postoperatively). Inhalation anesthetics are associated with increased blood loss (p<0.001). GA with premedication: The cyclooxygenase (COX)-2 inhibitor etoricoxib; the nonselective COX inhibitors lornoxicam, diclofenac and ketorolac IM; and the opioid nalbuphine improved postoperative pain. Nonpharmacological intervention: Listening to music decreased procedural pain. No major complication was observed. CONCLUSIONS: Conscious sedation, GA and some nonpharmacological interventions decreased procedural and postoperative pain, while being safe and satisfactory to patients. Data on the widely used PCB are inadequate to support its use, and it needs to be further studied to determine any benefit.

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药物靶点

药物	目标	类	生物	药理作用	行动
Lornoxicam	前列腺素合成酶1 G / H	蛋白质	人类	是的	抑制剂	细节
Lornoxicam	前列腺素合成酶2 G / H	蛋白质	人类	是的	抑制剂	细节