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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Published: Oct 1, 2019
DOI: https://doi.org/10.14456/tjog.2019.23
Keywords:
fractional curettage lidocaine spray intrauterine lidocaine paracervical block pain score visual analog scale

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Pinya Aupongkaroon
Department of Obstetrics and Gynecology, Khon Kaen Hospital, Khon Kaen, Thailand
Chinnawat Srinil
Department of Obstetrics and Gynecology, Khon Kaen Hospital, Khon Kaen, Thailand
Maleechat Sripipattanakul
Department of Obstetrics and Gynecology, Khon Kaen Hospital, Khon Kaen, Thailand
Thumwadee Tangsiriwatthana
Department of Obstetrics and Gynecology, Khon Kaen Hospital, Khon Kaen, Thailand

Abstract

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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How to Cite
(1)
Aupongkaroon, P.; Srinil, C.; Sripipattanakul, M.; Tangsiriwatthana, T. Comparison of Lidocaine Spray in Conjunction With Intrauterine Lidocaine Versus Paracervical Block for Pain Relief in Fractional and Curettage: A Randomized Controlled Trial. Thai J Obstet Gynaecol 2019, 27, 180-186.
Issue
VOL. 27, NO. 4: (October - December 2019)
Section
Original Article

References

1. Doraiswami S, Johnson T, Rao S, Rajkumar A, Vijayaraghavan J, Panicker VK. Study of endometrial pathology in abnormal uterine bleeding. J Obstet Gynaecol India 2011;61:426-30.
2. Alwardt CM, Redford D, Larson DF. General anesthesia in cardiac surgery: A review of drugs and practices. J Extra Corpor Technol 2005;37:227-35.
3. Grimes DA, Cates W Jr. Deaths from paracervical anesthesia used for first trimester abortion, 1972–1975. N Engl J Med 1976;295:1397-9.
4. Tangsiriwatthana T, Sangkomkamhang US, Lumbiganon P, Laopaiboon M. Paracervical local anaesthesia for cervical dilatation and uterine intervention. Cochrane Database Syst Rev 2013:9:CD005056.
5. Açmaz G, Aksoy H, Özoğlu N, Aksoy Ü, Albayrak E. Effect of paracetamol, dexketoprofen trometamol, lidocaine spray, and paracervical block application for pain relief during suction termination of first-trimester pregnancy. Biomed Res Int 2013;2013:869275.
6. Api O, Ergen B, Api M, Ugurel V, Emeksiz MB, Unal O. Comparison of oral nonsteroidal analgesic and intrauterine local anesthetic for pain relief in uterine fractional curettage: a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol 2010;203:28.e1-7.
7. Arora A, Shukla A, Saha SC. Effectiveness of Intrauterine Lignocaine in Addition to Paracervical Block for Pain Relief during Dilatation and Curettage, and Fractional Curettage. J Obstet Gynaecol India 2016;66:174-9.
8. Leelasuwattanakul N, Patipannawat S. Intrauterine Lidocaine versus Placebo in Conjunction with Paracervical Block for Pain Relief During Fractional Curettage: a Randomized Controlled Trial. Khon Kaen Med J 2012;36:44-9.
9. Açmaz G, Bayraktar E, Aksoy H, Başer M, Yilmaz MO, Müderris İİ. Effect of paracetamol, dexketoprofen trometamol, lidocaine spray, pethidine & diclofenac sodium application for pain relief during fractional curettage: A randomized controlled trial. Indian J Med Res 2015;142:399-404.
10. Açmaz G, Aksoy H, Özoğlu N, Aksoy Ü, Albayrak E. Effect of Paracetamol, Dexketoprofen Trometamol, Lidocaine Spray, and Paracervical Block Application for Pain Relief during Suction Termination of First-Trimester Pregnancy. BioMed Research International 2013;2013:1-5.
11. Rogers RM. Basic pelvic neuroanatomy. In: Steege JF, Metzger DA, Levy BS, editors. Chronic pelvic pain: an integrated approach. Philadelphia, PA: WB Saunders Company 1998:31-58.
12. Last RJ. Anatomy: Regional and Applied. 7th Edition. Churchill Livingstone, London 1984:336.
13. Edelman A, Nichols MD, Leclair C, Astley S, Shy K, Jensen JT. Intrauterine lidocaine infusion for pain management in first trimester abortions. Obstet Gynecol 2004;103:1267-72.