经阴分娩史对非插管静脉全麻下宫腔镜手术患者术中血流动力学及术后恢复情况的影响

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Abstract Objective To evaluate the influence of vaginal delivery history on the intraoperative hemodynamics and postoperative recovery in patients treated with hysteroscopic surgery under intravenous general anesthesia without tracheal intubation.Methods Four hundred and ninety-eight patients admitted into the First Medical Center of PLA General Hospital who were treated with hysteroscopic surgery under intravenous general anesthesia without tracheal intubation were divided into vaginal delivery history group (VD group) and no vaginal delivery history group (NVD group). The baseline conditions of the two groups were matched by propensity score. The changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) and heart rate (HR) before anesthesia (T₁), 1 minute after anesthesia (T₂), the beginning of operation (T₃) and 5 minutes after operation (T₄) between the two groups were compared, and the postoperative pain NRS score, nausea and vomiting were also compared.Results After propensity score matching, 354 patients (177 in NVD group and 177 in VD group) were enrolled in the analysis. There was no significant difference in SBP, DBP, MAP and HR between the two groups at T₁ and T₂ time points. At T₃ and T₄ time points, NVD group showed increased SBP, DBP, MAP and HR than those in VD group (P<0.01). There was no differences in SpO₂ between the two groups at T₃, while the SpO₂ was lower in NVD group at T₄. The surgery time didn’t show differences. VD group patients showed shorter postoperative awake time and hospital departure time (P<0.01), lower postoperative pain NRS score (P<0.01), and lower incidence of postoperative nausea and vomiting (P<0.01).Conclusion The history of vaginal delivery has an impact on the intraoperative hemodynamics and postoperative recovery quality in patients treated with hysteroscopic surgery under intravenous general anesthesia without tracheal intubation, which suggests that the anesthesia management protocols and medication strategy should be individually adjusted for patients with or without a history of vaginal delivery.

Key words： history of vaginal delivery general intravenous anesthesia hysteroscopy hemodynamics

Received: 26 March 2022

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	Articles by authors
	YU Xiaomeng
	WANG Miaomiao
	YAN Zhifeng
	LOU Jingsheng
	TIAN Ye

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YU Xiaomeng,WANG Miaomiao,YAN Zhifeng等. Influence of vaginal delivery history on intraoperative hemodynamics and postoperative recovery in patients treated with hysteroscopic surgery under intravenous general anesthesia without tracheal intubation[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(7): 581-585.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2022/V33/I7/581

[1]	夏恩兰.宫腔镜手术并发症诊治现状及展望[J].中国实用妇科与产科杂志,2015,31(5): 369-373.
[2]	陈鹏,杨清.日间宫腔镜手术的经验分析[J]. 中国医科大学学报, 2019,48(12):1147-1149.
[3]	ACOG Committee Opinion. The use of hysteroscopy for the diagnosis and treatment of intrauterine pathology: number 800[J]. Obstet Gynecol, 2020, 135(3): e138-e148.
[4]	韩肇艺.宫腔镜手术的麻醉处理和体会[J].临床麻醉学杂志, 2003,19(1): 53-54.
[5]	Kumar G, Stendall C, Mistry R. et al. A comparison of total intravenous anaesthesia using propofol with sevoflurane or desflurane in ambulatory 55 surgery: Systematic review and meta-analysis [J]. Anaesthesia, 2014,69(10):1138-1150.
[6]	颜娅.静脉麻醉下宫腔镜日间手术的临床观察[J].临床麻醉学杂志,2016,32(10):1003-1004.
[7]	孔亮.宫腔镜诊治术前宫颈预处理方法研究进展[J].北京医学, 2020,42(4):323-326.
[8]	Mazzon I,Favilli A,Horvath S,et al.Pain during diagnostic hysteroscopy:what is the role of the cervical canal?A pilot study[J].Eur J Obstet Gynecol Reprod Biol, 2014, 265(183):169-173.
[9]	孙雪梅,张雷,毛煜,等.既往分娩史对无痛宫腔镜患者丙泊酚用量的影响[J]. 医学研究生学报,2019, 32(10):1059-1063.
[10]	Kumar S, Srivastava A, Sharma S, et al. One-year continuation of postpartum intrauterine contraceptive device: findings from a retrospective cohort study in India[J]. Contraception, 2019, 99 (4): 212-216.
[11]	全紫薇.绝经期女性宫腔操作的相关问题[J].医学研究杂志,2019,48(8):186-188,157.
[12]	黄晓武,夏恩兰.宫颈组织结构与宫颈机能[J].国际妇产科学杂志, 2016, 43(6): 657-660.
[13]	江志伟,李宁,黎介寿.快速康复外科的概念及临床意义[J].中国实用外科杂志, 2007,27(2):131-133.
[14]	中华医学会外科学分会与中华医学会麻醉学分会.加速康复外科中国专家共识及路径管理指南(2018版)[J].中国实用外科杂志, 2018, 38(1): 562-569.
[15]	Hassan A, Haggag H, Wahba A, et al. Tramadol versus Celecoxib for reducing pain associated with outpatient hysteroscopy: a randomized double-blind placebo-controlled trial [J]. Hum Reprod, 2016,31(1): 60-66.
[16]	中华医学会妇产科学分会妇科内镜学组. 宫腔镜手术子宫颈预处理临床实践指南[J]. 中华妇产科杂志, 2020, 55(12): 813-818.
[17]	中华医学会妇产科学分会妇科内镜学组. 指南发布:促进宫腔镜手术子宫颈预处理的规范化[J].中华医学信息导报, 2021, 36(1):14.
[18]	曹淑萍,熊化军,姜萍.无痛人工流产术中丙泊酚用量与不同生育史的关系[J].中国妇幼保健, 2009,24(28):3990-3991.
[19]	曾祥玉,徐阳.无痛人流时丙泊酚用量与年龄的关系[J].临床麻醉学杂志, 2007, 23(8):704.
[20]	Biela M M, Doniec J, Szafarowska M, et al. Is every patient eligible to have an office hysteroscopy? A retrospective analysis of 1301 procedures[J]. Wideochir Inne Tech Maloinwazyjne, 2020, 15(2):337-345.