Hysteroscopic surgery local anesthesia method

Abstract

The invention relates to the technical field of gynecological minimally invasive surgery, in particular to a hysteroscopic surgery local anesthesia method which specifically comprises the following steps: S1, preoperative preparation; s2, pre-operation pretreatment is carried out; s3, local anesthesia of the vagina; s4, local infiltration anesthesia of the cervix uteri; the vagina local anesthesia is specifically as follows: 10ml of lidocaine gel is injected into the vagina, and the cervical local infiltration anesthesia is specifically as follows: 0.1 mg of lidocaine is added into 5ml of 0.9% sodium chloride for dilution to form a diluent of 0.1 mg of lidocaine added into 5ml of 0.9% sodium chloride, and the diluent is injected at 3 o'clock and 9 o'clock respectively. Side effects of nausea, vomiting, dizziness and the like after anesthesia are reduced, the recovery is faster, the hospitalization time and the post-operation hospital staying time are shortened, the patient can walk back to a ward after operation and can be discharged from the hospital after one hour after operation, and more convenience is brought to the patient.

Description

Technical Field

[0001] The present invention relates to the technical field of gynecological minimally invasive surgery, and in particular to a local anesthesia method for hysteroscopic surgery. Background Art

[0002] Hysteroscopic surgery is a common minimally invasive gynecological surgery, which plays an important role in the diagnosis and treatment of various intrauterine diseases, such as endometrial polyps, submucosal myomas, intrauterine adhesions, etc. Due to its advantages of less trauma and faster recovery, it is widely used in clinical practice.

[0003] During hysteroscopic surgery, effective anesthesia is a key factor in ensuring the smooth progress of the operation and alleviating the patient's pain. Local anesthesia has become one of the commonly used anesthesia methods in hysteroscopic surgery due to its relatively simple operation and fewer complications. However, the current existing hysteroscopic local anesthesia methods have some limitations. For example, a single local anesthesia method may not achieve the ideal anesthetic effect, causing the patient to still feel obvious pain and discomfort during the operation, which not only affects the patient's surgical experience, but may also cause certain interference to the surgical operation and increase the risk of the operation. For this reason, we proposed a local anesthesia method for hysteroscopic surgery. Summary of the invention

[0004] The purpose of the present invention is to solve the problem that a single local anesthesia method in the prior art may not achieve the ideal anesthetic effect, resulting in the patient still feeling obvious pain and discomfort during the operation, which not only affects the patient's surgical experience, but may also cause certain interference to the surgical operation and increase the risk of the operation, and a local anesthesia method for hysteroscopic surgery is proposed.

[0005] In order to achieve the above object, the present invention adopts the following technical solutions:

[0006] A method for local anesthesia for hysteroscopic surgery, the specific method is as follows:

[0007] S1. Preoperative preparation;

[0008] S2, preoperative treatment;

[0009] S3, local vaginal anesthesia;

[0010] S4, local infiltration anesthesia of the cervix;

[0011] S5. Actual observation after anesthesia.

[0012] Preferably, the preoperative preparation includes patient assessment and item preparation, and the patient assessment specifically includes:

[0013] Patient medical history collection: Inquire about the patient's medical history in detail, including drug allergy history, especially whether they have allergic reactions to diclofenac sodium, ibuprofen, lidocaine and other drugs; understand the patient's pain tolerance, previous surgical anesthesia history, whether they have cardiovascular disease, liver and kidney function abnormalities, etc., in order to assess the patient's tolerance and safety of the anesthesia method;

[0014] Patient physical examination: Conduct a comprehensive physical examination, focusing on whether the patient's vital signs (such as body temperature, blood pressure, heart rate, breathing, etc.) are stable, and assess the patient's cardiopulmonary function; check the patient's vagina and cervix to rule out factors such as vaginal inflammation and cervical malformation that may affect anesthesia and surgery;

[0015] Laboratory tests: Patients are required to undergo necessary laboratory tests, such as blood routine, coagulation function, liver and kidney function, etc., to understand the patient's general health status and coagulation function, and to ensure that the patient can tolerate anesthesia and surgery.

[0016] Preferably, the article preparation specifically includes:

[0017] Anesthetic drugs: prepare diclofenac sodium suppositories or ibuprofen suppositories, lidocaine gel, lidocaine injection, 0.9% sodium chloride injection and other drugs, and check the expiration date and quality of the drugs to ensure that the drugs are safe and effective;

[0018] Instruments and equipment: prepare anal cuffs, vaginal speculum, syringes, disinfectants (such as iodine, alcohol, etc.), sterile gloves and other instruments and supplies, and ensure they are clean and sterile.

[0019] Preferably, the preoperative pretreatment is specifically as follows: one hour before the operation, in addition to taking a diclofenac sodium suppository or ibuprofen suppository as an anal plug, 0.3g of gabapentin capsule can be taken orally. Gabapentin can regulate the pain signal transmission of the central nervous system, enhance the preoperative analgesic effect, and reduce the pain sensation during surgery from the neural level.

[0020] Preferably, the local vaginal anesthesia is specifically: 10 ml of lidocaine gel injected into the vagina.

[0021] Preferably, the lidocaine gel can also be replaced by compound lidocaine gel, which contains not only lidocaine but also prilocaine. The synergistic effect of the two can more effectively and durably block the generation and conduction of nerve impulses and enhance the local anesthesia effect of the vagina.

[0022] Preferably, the local infiltration anesthesia of the cervix is ​​specifically: 0.1 mg of lidocaine is diluted with 5 ml of 0.9% sodium chloride and injected at the 3 o'clock and 9 o'clock positions of the cervix.

[0023] Preferably, the dilution of 0.1 mg lidocaine added to 5 ml of 0.9% sodium chloride can be replaced by 0.25% ropivacaine solution. Compared with lidocaine, ropivacaine has sensory-motor separation characteristics. While effectively anesthetizing, it has less effect on motor nerves, can reduce patient discomfort during surgery, and has a longer duration of action.

[0024] Preferably, 3 ml of 0.25% ropivacaine solution is injected at 3 and 9 o'clock on the cervix, and combined with ultrasound-guided precision injection technology and real-time ultrasound imaging, anesthetic drugs can be more accurately injected around the paracervical nerves, thereby improving the anesthetic effect and reducing drug dosage and adverse reactions.

[0025] Preferably, the post-anesthesia real-time observation specifically includes: Vital sign monitoring: After the anesthesia operation is completed, the patient's vital signs, including blood pressure, heart rate, respiration, blood oxygen saturation, etc., should be closely observed and recorded every 5-10 minutes until the vital signs are stable;

[0026] Pain assessment: Ask the patient about their pain experience and use appropriate pain assessment methods (such as visual analog scale, etc.) to assess the patient's pain level. If the patient still has obvious pain, analyze the cause in time and take appropriate treatment measures, such as adding local anesthetics or giving other analgesics;

[0027] Adverse reaction observation: observe whether the patient has adverse reactions such as dizziness, nausea, vomiting, rash, and whether there are symptoms of lidocaine poisoning, such as numbness of the mouth and tongue, blurred vision, muscle tremors, convulsions, etc. Once an adverse reaction is found, it should be treated immediately.

[0028] The local anesthesia method for hysteroscopic surgery proposed by the present invention has the following beneficial effects:

[0029] No need to fast for 6-8 hours, which can reduce the patient's discomfort.

[0030] Reduce side effects such as nausea, vomiting, and dizziness after anesthesia.

[0031] Recover faster and spend less time in the hospital and after surgery.

[0032] Patients can be diagnosed and treated as soon as they arrive. They can walk back to the ward after surgery and be discharged from the hospital 1 hour after surgery, which makes it more convenient for them.

[0033] The operation is quick, the patient can intuitively understand the intraoperative situation, and it is convenient for the patient to communicate with the surgeon during the operation.

[0034] Multiple methods are combined for local anesthesia. The patient has basically no discomfort during and after the operation. Hysteroscopy and surgery can be performed smoothly, and the effect is similar to that of general anesthesia. DETAILED DESCRIPTION

[0035] The technical solutions in the embodiments of the present invention will be clearly and completely described below in combination with the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, rather than all the embodiments.

[0036] A method for local anesthesia for hysteroscopic surgery, the specific method is as follows:

[0037] S1. Preoperative preparation: Preoperative preparation includes patient assessment and material preparation. Patient assessment includes: Patient medical history collection: Detailed inquiry of the patient's medical history, including history of drug allergies, especially whether the patient has allergic reactions to diclofenac sodium, ibuprofen, lidocaine and other drugs; understanding the patient's pain tolerance, previous surgical anesthesia history, cardiovascular disease, liver and kidney dysfunction, etc., in order to assess the patient's tolerance and safety to the anesthesia method;

[0038] Patient physical examination: Conduct a comprehensive physical examination, focusing on whether the patient's vital signs (such as body temperature, blood pressure, heart rate, breathing, etc.) are stable, and assess the patient's cardiopulmonary function; check the patient's vagina and cervix to rule out factors such as vaginal inflammation and cervical malformation that may affect anesthesia and surgery;

[0039] Laboratory tests: Patients are required to undergo necessary laboratory tests, such as blood routine, coagulation function, liver and kidney function, etc., to understand the patient's general health status and coagulation function, and to ensure that the patient can tolerate anesthesia and surgery.

[0040] The specific items to be prepared are:

[0041] Anesthetic drugs: prepare diclofenac sodium suppositories or ibuprofen suppositories, lidocaine gel, lidocaine injection, 0.9% sodium chloride injection and other drugs, and check the expiration date and quality of the drugs to ensure that the drugs are safe and effective;

[0042] Instruments and equipment: prepare anal cuffs, vaginal speculum, syringes, disinfectants (such as iodine, alcohol, etc.), sterile gloves and other instruments and supplies, and ensure they are clean and sterile.

[0043] S2. Preoperative pretreatment: Preoperative pretreatment is as follows: one hour before surgery, in addition to taking a diclofenac sodium suppository or ibuprofen suppository, you can also take 0.3g of gabapentin capsule orally. Gabapentin can regulate the pain signal transmission of the central nervous system, enhance the preoperative analgesic effect, and reduce the pain sensation during surgery from the neural level.

[0044] Operation method: Let the patient lie on his side, bend his knees, and expose the anus. The operator puts on an anal finger sleeve, takes out the diclofenac sodium suppository or ibuprofen suppository, and gently inserts the suppository into the anus with the tip facing the anus to a depth of about 2-3 cm to ensure that the suppository will not fall out.

[0045] Note: Before the operation, explain the purpose of the operation and possible sensations to the patient to relieve the patient's nervousness. Be gentle during the operation to avoid damaging the anal and rectal mucosa. Inform the patient that during the dissolution and absorption of the suppository, there may be a slight feeling of anal swelling, which is normal and there is no need to be too nervous.

[0046] S3, local vaginal anesthesia; 10ml of lidocaine gel injected into the vagina,

[0047] Operation method: The patient takes the lithotomy position, routinely disinfects the vulva and vagina, lays a sterile towel, uses a vaginal speculum to fully expose the cervix, and slowly injects 10 ml of lidocaine gel into the vagina, especially ensuring that the gel fully covers the cervix and vaginal vault. A syringe can be used to evenly spray or apply the gel to the relevant area.

[0048] Note: The operation process must strictly follow the principle of sterility to prevent infection. When injecting the gel, pay attention to observe the patient's reaction, such as pain, burning sensation and other discomfort symptoms. If the patient is obviously uncomfortable, the operation should be stopped immediately and appropriate treatment should be taken.

[0049] S4. Local infiltration anesthesia of the cervix: dilute 0.1 mg of lidocaine with 5 ml of 0.9% sodium chloride.

[0050] At 3 o'clock and 9 o'clock on the cervix, 0.1 mg of lidocaine was added to 5 ml of 0.9% sodium chloride dilution or 3 ml of 0.25% ropivacaine solution. At the same time, the precise injection technology under ultrasound guidance and real-time ultrasound imaging can more accurately inject anesthetic drugs around the cervical nerves, thereby improving the anesthesia effect and reducing the dosage of drugs and adverse reactions.

[0051] Operation preparation: Use a syringe to draw out 0.1 mg of lidocaine, add it to 5 ml of 0.9% sodium chloride injection, mix thoroughly, and prepare diluted lidocaine injection.

[0052] Operation method: After strict disinfection of the cervix, use a syringe to extract the diluted lidocaine injection. Insert the syringe needle into the submucosal membrane at 3 o'clock and 9 o'clock of the cervix, with a depth of about 0.5-1cm. After no blood is returned, slowly inject 5ml of diluted lidocaine injection each time. During the injection, pay attention to observe the patient's complexion, expression, vital signs, etc. If there is any abnormality, stop the operation in time.

[0053] Note: Before injection, be sure to draw back to avoid injecting the drug into the blood vessels and causing lidocaine poisoning. Push the injection slowly to avoid excessive local pressure, which may cause pain and tissue damage. After injection, observe the injection site for bleeding, swelling, etc. If bleeding occurs, apply compression to stop bleeding in a timely manner.

[0054] S5. Live observation after anesthesia. Live observation after anesthesia includes: Vital signs monitoring: After the anesthesia operation is completed, the patient's vital signs, including blood pressure, heart rate, respiration, blood oxygen saturation, etc., should be closely observed, and recorded every 5-10 minutes until the vital signs are stable;

[0055] Pain assessment: Ask the patient about their pain experience and use appropriate pain assessment methods (such as visual analog scale, etc.) to assess the patient's pain level. If the patient still has obvious pain, analyze the cause in time and take appropriate treatment measures, such as adding local anesthetics or giving other analgesics;

[0056] Adverse reaction observation: observe whether the patient has adverse reactions such as dizziness, nausea, vomiting, rash, and whether there are symptoms of lidocaine poisoning, such as numbness of the mouth and tongue, blurred vision, muscle tremors, convulsions, etc. Once an adverse reaction is found, it should be treated immediately.

Claims

1. A method for local anesthesia in hysteroscopic surgery, characterized in that: The specific method is as follows: S1. Preoperative preparation; S2, preoperative treatment; S3, local vaginal anesthesia; S4, local infiltration anesthesia of the cervix; S5. Actual observation after anesthesia.

2. A method for local anesthesia for hysteroscopic surgery according to claim 1, characterized in that: The preoperative preparation includes patient assessment and item preparation. The patient assessment specifically includes: Patient medical history collection: Inquire about the patient's medical history in detail, including drug allergy history, especially whether they have allergic reactions to diclofenac sodium, ibuprofen, lidocaine and other drugs; understand the patient's pain tolerance, previous surgical anesthesia history, whether they have cardiovascular disease, liver and kidney function abnormalities, etc., in order to assess the patient's tolerance and safety of the anesthesia method; Patient physical examination: Perform a comprehensive physical examination, focusing on whether the patient's vital signs (such as body temperature, blood pressure, heart rate, breathing, etc.) are stable, and assess the patient's cardiopulmonary function; check the patient's vagina and cervix to exclude factors such as vaginal inflammation and cervical malformation that may affect anesthesia and surgery; Laboratory tests: Patients are required to undergo necessary laboratory tests, such as blood routine, coagulation function, liver and kidney function, etc., to understand the patient's general health status and coagulation function, and to ensure that the patient can tolerate anesthesia and surgery.

3. A method for local anesthesia for hysteroscopic surgery according to claim 2, characterized in that: The items to be prepared are specifically: Anesthetic drugs: prepare diclofenac sodium suppositories or ibuprofen suppositories, lidocaine gel, lidocaine injection, and 0.9% sodium chloride injection, and check the expiration date and quality of the drugs to ensure that the drugs are safe and effective; Instruments and equipment: prepare anal gloves, vaginal speculum, syringes, disinfectants (such as iodine, alcohol, etc.), sterile gloves, instruments and supplies, and ensure they are clean and sterile.

4. A method for local anesthesia for hysteroscopic surgery according to claim 1, characterized in that: The specific preoperative treatment is: one hour before the operation, in addition to a diclofenac sodium suppository or ibuprofen suppository, 0.3g of gabapentin capsule can be taken orally. Gabapentin can regulate the pain signal transmission of the central nervous system, enhance the preoperative analgesic effect, and reduce the pain sensation during surgery from the neural level.

5. A method for local anesthesia for hysteroscopic surgery according to claim 1, characterized in that: The vaginal local anesthesia specifically includes: 10 ml of lidocaine gel injected into the vagina.

6. A method for local anesthesia for hysteroscopic surgery according to claim 5, characterized in that: The lidocaine gel can also be replaced by compound lidocaine gel, which contains not only lidocaine but also prilocaine. The synergistic effect of the two can more effectively and durably block the generation and conduction of nerve impulses, thereby enhancing the local anesthesia effect of the vagina.

7. A method for local anesthesia for hysteroscopic surgery according to claim 1, characterized in that: The local infiltration anesthesia of the cervix is ​​specifically as follows: 0.1 mg of lidocaine is diluted with 5 ml of 0.9% sodium chloride to form a diluted solution of 0.1 mg of lidocaine added with 5 ml of 0.9% sodium chloride, and the diluted solution is injected at the 3 o'clock and 9 o'clock positions of the cervix.

8. A method for local anesthesia for hysteroscopic surgery according to claim 7, characterized in that: The dilution of 0.1 mg lidocaine added to 5 ml of 0.9% sodium chloride can be replaced by 0.25% ropivacaine solution. Compared with lidocaine, ropivacaine has the characteristics of sensory-motor separation. While effectively anesthetizing, it has less effect on motor nerves, can reduce patient discomfort during surgery, and has a longer duration of action.

9. A method for local anesthesia for hysteroscopic surgery according to claim 1, characterized in that: The post-anesthesia real-time observation specifically includes: Vital signs monitoring: After the anesthesia operation is completed, the patient's vital signs, including blood pressure, heart rate, respiration, blood oxygen saturation, etc., should be closely observed and recorded every 5-10 minutes until the vital signs are stable; Pain assessment: Ask the patient about their pain experience and use appropriate pain assessment methods (such as visual analog scale, etc.) to assess the patient's pain level. If the patient still has obvious pain, analyze the cause in time and take appropriate treatment measures, such as adding local anesthetics or giving other analgesics; Adverse reaction observation: observe whether the patient has adverse reactions such as dizziness, nausea, vomiting, rash, and whether there are symptoms of lidocaine poisoning, such as numbness of the mouth and tongue, blurred vision, muscle tremors, convulsions, etc. If any adverse reaction is detected, it should be dealt with immediately.