超声引导骶神经阻滞在宫颈癌腔内和/或间质性放疗中的临床价值
The clinical value of ultrasound-guided sacral anesthesia in Intracavitary and/or interstitial brachytherapy for cervical Cancer
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影响因子:4.1
分区:医学2区 Top / 妇产科学1区 肿瘤学2区
发表日期:2024 Dec
作者:
Xiaojing Yang, Chen Li, Zhen Li, Dongping Du, Jie Fu
DOI:
10.1016/j.ygyno.2024.09.014
摘要
本研究旨在探讨超声引导骶神经阻滞在宫颈癌腔内和/或间质性放疗中的效果与安全性。回顾分析2020年12月7日至2024年3月21日期间我科220名患者共1039次腔内和/或间质放疗的资料。评估内容包括麻醉满意度、生命体征变化、麻醉起效时间、麻醉药物用量、麻醉持续时间以及不良反应发生率。麻醉满意度达73.8%。麻醉前后心率（HR）、平均动脉压（MAP）、收缩压（SBP）和血氧饱和度（SaO2）差异无统计学意义（P>0.05）。麻醉起效时间为20-35分钟，平均用药量为20毫升，持续时间30-120分钟。严重不良反应包括2例与骶囊肿相关的麻醉后晕厥。恶心发生率为2.2%，其他不良反应如呕吐、尿潴留、缓慢心率、肛门不适和头晕的发生率均低于1%。超声引导骶神经阻滞显示出显著优势，包括有效麻醉、对生命体征影响小、起效快、维持时间长、不良反应发生率低，推荐在宫颈癌腔内和/或间质放疗中广泛应用。
Abstract
To explore the effectiveness and safety of ultrasound-guided sacral anesthesia in intracavitary and/or interstitial brachytherapy for cervical cancer patients.A retrospective analysis was conducted on a total of 1039 intracavitary and/or interstitial brachytherapy involving 220 patients in our department from December 7, 2020 to March 21, 2024. The study assessed the satisfaction with anesthesia, changes in vital signs, onset time of anesthesia, dosage of anesthetic drugs, duration of anesthesia, and incidence of adverse reactions.The rate of satisfaction with anesthesia was 73.8 %. There were no significant differences in patients' heart rate (HR), mean arterial pressure (MAP), systolic blood pressure (SBP), or oxygen saturation (SaO2) before and after anesthesia (P > 0.05). The onset time of anesthesia ranged from 20 to 35 min, the average dosage of anesthetic was 20 ml, and the duration of anesthesia lasted from 30 to 120 min. Serious adverse reactions included 2 cases of post-anesthesia syncope (associated with sacral cysts). The incidence of nausea was 2.2 %, and the total incidence of other adverse reactions, such as vomiting, urinary retention, bradycardia, anal discomfort, and dizziness, was less than 1 %.Ultrasound guided sacral anesthesia demonstrates significant advantages, including effective anesthesia, minimal impact on vital signs, rapid onset, prolonged maintenance, and a low incidence of adverse reactions. It is recommended for widespread application in intracavitary and/or interstitial brachytherapy for cervical cancer patients.