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一般对局部麻醉在循环电外科切除手术程序:一个系统的审查和元分析
Rafaela Germano Toledo, Yasmin Dias1, Rafael R H Martin
1Department of Obstetrics and Gynecology, University of Missouri Kansas City, Kansas City, MO.
在循环电外科切除 (LEEP) 程序中,局部麻醉 (LA) 可能是可取的. 虽然全身麻醉 (GA) 在疼痛和满意度方面显示出最小的,无意义的改善,但它与更大的切除有关,可能会影响未来的怀孕.
科学领域:
- 妇科 妇科医生 妇科
- 手术瘤学手术瘤学
- 麻醉学 麻醉学
背景情况:
- 循环电外科切除 (LEEP) 是高度宫内皮质瘤的标准治疗方法.
- 患者报告的结果对于评估LEEP程序中的麻醉选择至关重要.
研究的目的:
- 为了比较患者报告的结果,特别是疼痛和满意度,在LEEP期间进行局部麻醉 (LA) 和全身麻醉 (GA).
- 评估患者在LEEP后再次选择相同麻醉方法的可能性.
主要方法:
- 一个系统的审查和对比GA和LA对LEEP的研究的元分析.
- 在PubMed,Embase和Cochrane数据库中进行了搜索.
- 使用随机效应模型分析了手术后的疼痛,满意度和圆体积.
主要成果:
- 其中包括6项涉及2169名患者的研究 (1536 LA, 633 GA).
- 在GA和LA之间,在术后疼痛或患者满意度方面没有统计学上显著的差异.
- GA与显著更大的圆体积相关 (0.46 cm3的差异).
结论:
- 无论是GA还是LA都没有在疼痛或满意度方面显示出临床上有意义的差异.
- 含有GA的较大的体积可能会对未来的怀孕构成风险.
- 考虑到GA的风险和成本较高,LA似乎是LEEP的首选选择.
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