Lidocaine Prilocaine Cream in Conjunction with Paracervical Block versus Placebo with Paracervical Block for Pain Relief during Fractional Curettage

Abstract

Objectives: To study the efficacy of lidocaine prilocaine cream apply at cervix in conjunction with paracervical block versus placebo with paracervical block for pain reduction during fractional curettage.
Materials and Methods: One hundred and six women who underwent fractional curettage at Khon Kaen Hospital were enrolled in a randomized, double-blinded, placebo-controlled trial. The participants were randomly allocated into two groups, received lidocaine prilocaine cream plus paracervical block applied onto cervix (n = 53) versus placebo cream plus paracervical block (n = 53) before performing fractional curettage. Pain score was measured at tenaculum placement, during procedure, immediately after and 30 minutes after the procedure, using a 10 centimeters visual analog scale (VAS). The adverse events and additional analgesia were also recorded.
Results: Baseline characteristics were similar between groups. Mean pain score during fractional curettage in lidocaine prilocaine cream plus paracervical block was significantly lower than placebo cream plus paracervical block (2.80 ± 0.29, 95% confidence interval (CI) 2.21-3.38 vs. 5.34 ± 0.39, 95%CI 4.55-6.13, p < 0.001). Adverse events such as lightheadedness, palpitation and tinnitus were found without statistically significant difference between groups. None of the participants requested an additional analgesia.
Conclusion: Lidocaine prilocaine cream in conjunction with paracervical block had better pain relief during fractional curettage than in control group without serious adverse events.