Comparison of Lidocaine Spray in Conjunction with Intrauterine Lidocaine versus Paracervical Block for Pain Relief in Fractional and Curettage: A randomized controlled trial

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Pinya Aupongkaroon
Chinnawat Srinil
Maleechat Sripipattanakul
Thumwadee Tangsiriwatthana


Objectives: To compare lidocaine spray plus intrauterine lidocaine versus paracervical block alone for pain relief during and at 30 minutes after fractional curettage.
Materials and Methods: One hundred and twelve women with abnormal uterine bleeding at Khon Kaen Hospital from January to April, 2018 were randomly allocated into two groups, receiving lidocaine spray in conjunction with intrauterine lidocaine (n=56) versus paracervical block (n=56) before fractional and curettage. Pain score during fractional curettage was measured by 100-mm visual analogue scale (VAS). Pain score after procedure and all adverse events were observed and recorded at 30 minutes after procedure by other doctors who did not perform fractional curettage. Moreover, additional analgesia or sedation, inadequacy of specimen were also recorded.
Results: Baseline characteristics were similar between groups. Pain score during procedure in lidocaine spray in conjunction with intrauterine lidocaine group was statistically significant lower than paracervical block group (71.5 (53.5-82.5) vs 50.5 (39-63), 95% CI 12.70-28.25, p < 0.001). There was no significant difference in pain score after procedure, adverse events, additional analgesia or sedation and inadequacy of specimen
Conclusion: Lidocaine spray in conjunction with intrauterine lidocaine have statistically significant difference for pain reduction compared with paracervical block during fractional and curettage without serious adverse events.


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