Objective: To develop a highly painless and effective form of anaesthesia for ovarian cystectomy.
Methods: Seventy-two ovarian cystectomy patients were recruited, from August 2012 to July 2015, from XXX hospital. They were randomly divided into the treatment group (n = 36) and the control group (n = 36) in a double-blinded prospective study. The patients in the control group were subjected to the regular rapid induction of anaesthesia, while those in the treatment group were treated with lidocaine-prilocaine cream (EMLA) for five minutes (n = 6), ten minutes (n = 6), 15 minutes (n = 6), 20 minutes (n = 6), 25 minutes (n = 6) and 30 minutes (n = 6) before surgery combined with the rapid induction of anaesthesia (LCRIA). Then, the data obtained from the patients were recorded, including haemodynamic fluctuations, tube tolerance time, sore throat and throat discomfort. Pain perception was scored using the visual analogue scale (VAS) during the ovarian cystectomy procedure in a telephone interview the following day.
Results: When extubation was performed, the diastolic blood pressure was (68.53 ± 5.64 mmHg versus 74.43 ± 5.82 mmHg); the systolic blood pressure was (112.43 ± 3.24 mmHg versus 123.04 ± 5.32 mmHg), and the mean arterial pressure was (81.23 ± 5.03 mmHg versus 86.43 ± 5.54 mmHg). The heart rate (87.43 ± 4.54 times/min versus 96.32 ± 5.11 times/minutes) of the patients in the treatment group increased significantly (p < 0.05), but lower than that of those in the control group. The endotracheal tube tolerance time of the patients in the treatment group was significantly longer (p < 0.05) than that of those in the control group (13.34 ± 2.43 minutes versus 10.03 ± 1.84 minutes). The incidence of a sore throat (5.41% versus 21.62%), and the incidence of pharyngeal discomfort (8.11% versus 35.14%) in the treatment group was significantly lower (p < 0.05) than that in the control group. When comparing the VAS pain scores, the patients with lidocaine-prilocaine cream 20 minutes before surgery (3.2 ± 0.56 minutes) suffered from significantly less pain (p < 0.05) than those in the control group (5.6 ± 1.74 minutes), and the least pain was in the treatment group.
Conclusion: The application of LCRIA can effectively reduce pain, relieve the haemodynamic fluctuations caused by extubation stress reaction during ovarian cystectomy, enhance tolerance to the endotracheal tube, and reduce the incidence of a sore throat.