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| Influence of perioperative blood volume management on the effect of painless induced abortion of patients with early missed abortion |
| Qionghai Hospital of Traditional Chinese Medicine, Qionghai, Hainan Province, 571400 |
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Abstract To explore the prevention of postoperative complications of the perioperative blood volume management for patients with early missed abortion after painless induced abortion. Methods: 158 patients with early missed abortion who wanted painless induced abortion were selected and were randomly divided into observation group (n=79) and control group (n=79) by random number table method from November 2020 to November 2021. The patients in the two groups were anesthetized with remifentanil injection combined with propofol, and the patients in the observation group were pretreated with blood volume expansion before anesthesia additionally. The operation time, the intraoperative blood loss, the propofol dosage, the levels of hemodynamic indexes and the pain score of visual analogue scale (VAS) at different time point before and after anesthesia, the changes of the levels of sex hormone indexes before and 3 months after operation, and the occurrences of adverse reactions and complications of the patients in the two groups were observed. Results: The propofol dosage of the patients in the observation group was significantly lower than that of the patients in the control group, the MAP value of the patients in the observation group at 5min after anesthesia was significantly higher than that of the patients in the control group, and the HR value of the patients in the observation group at 1min, 5min, or 10min after anesthesia was significantly lower than that of the patients in the control group. The VAS scores of the patients in the observation group at 6h, 12h, and 24h after operation were significantly lower than those of the patients in the control group. The levels of luteinizing hormone and follicle stimulating hormone of the patients in the observation group at 3 months after operation were significantly higher than those of the patients in the control group, while the levels of the estradiol and anti-Muller's hormone of the patients in the observation group were significantly lower. The incidences of the decreased blood pressure (15.2%), the increased heart (20.3%), the dizziness (10.1%), the nausea and vomiting (0) of the patients in the observation group were significantly lower than those (46.8%, 54.4%, 38.0%, and 10.1%) of the patients in the control group. In 3 months after operation, the total complication rate (5.1%) of the patients in the observation group was significantly lower than that (20.3%) of the patients in the control group (all P＜0.05). Conclusion: The perioperative blood volume management of painless induced abortion of the patients with early missed abortion can effectively reduce the dosage of anesthetics, stabilize the hemodynamics, reduce the operative pain and the reproductive function damage of the patients, and can decrease the incidences of adverse reactions and complications.
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