一个双盲,三臂随机受控试验,使用1%的利多卡因进行宫阻断,以插入子宫内装置 (IUD)
Abirami Kirubarajan1, Anna Gryn2, Megan Werger3
1Department of Obstetrics & Gynecology, McMaster University; Department of Obstetrics and Gynaecology, University of Toronto; Department of Obstetrics and Gynecology, Mount Sinai Hospital.
Contraception
|January 26, 2026
概括
宫阻断显著减少了宫内器件 (IUD) 插入期间的疼痛,特别是在无子宫患者中. 这种手术提供了更好的舒适度和满意度,使宫内避孕器更受欢迎.
科学领域:
- 生殖医学和避孕方法
- 在妇科手术中治疗疼痛.
背景情况:
- 宫内器件 (IUD) 插入可能会带来严重的疼痛,可能会影响患者的接受和坚持.
- 与多倍体患者相比,无双体患者在IUD放置期间经常报告更高的疼痛水平.
- 有效的疼痛管理策略对于改善IUD插入期间的患者体验至关重要.
研究的目的:
- 评估宫阻断在宫内器械 (IUD) 插入期间减轻疼痛的疗效.
- 为了比较接受椎阻塞,盐水注射或盖针的患者之间的疼痛得分.
- 在各种程序阶段评估患者的满意度和疼痛感知.
主要方法:
- 一个随机的,双盲的,三臂试验,涉及246名接受IUD插入的患者.
- 干预措施包括宫阻塞 (利多卡因1%与上腺素10毫升),盐水注射或盖着针.
- 主要结局是100毫米视觉模拟尺度上的全球疼痛评分;次要结局包括手术疼痛和患者满意度.
主要成果:
- 与盐水 (中位数45毫米) 和封闭针 (中位数45毫米) 组相比,接受宫阻塞的患者报告了明显较低的全球疼痛评分 (中位数30毫米) (p<0.01).
- 宫阻塞在无体参与者 (中位数40毫米) 与盐水 (中位数50毫米) 和盖针 (中位数60毫米) (p<0.001) 相比,显著减少了疼痛 (p<0.001).
- 在所有IUD插入时间点观察到疼痛减轻,与封顶针组相比,在宫阻塞组报告的患者满意度更高 (p<0.01).
结论:
- 宫阻塞有效地减少了IUD插入期间的全身疼痛,对无子宫患者有显著的益处.
- 该程序与最小的注射疼痛相关,并提高了患者的整体满意度和舒适度.
- 研究结果支持将宫阻塞整合到常规IUD插入协议中,以改善患者体验和避孕方法的可接受性.
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