Lidocaine Prilocaine Cream versus Intracervical Injection for Pain Relief during Loop Electrosurgical Excision Procedure
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Abstract
Objectives: To compare the effectiveness between lidocaine prilocaine cream versus intracervical injection for pain relief during loop electrosurgical excision procedure (LEEP).
Materials and Methods: Sixty women who underwent LEEP at Khon Kaen Hospital were enrolled in a single, blinded, non-inferiority randomized controlled trial. The participants were randomly allocated into two groups; group 1 received lidocaine prilocaine cream applied to the cervix (n = 30), and group 2 intracervical injection (n = 30) before performing LEEP. The pain score was measured at speculum placement, during anesthetization, during the procedure, immediately after, and 30 min after the procedure, using the 10-cm visual analogue scale (VAS). In addition, we recorded adverse events and additional analgesia.
Results: Baseline characteristics were similar between groups. The mean pain score during LEEP among groups was not significantly different between intracervical injections (control group) (5.53 ± 0.46, 95% confidence interval (CI) 4.60-6.47 vs. 4.59 ± 0.44, 95%CI 3.68-5.50, p = 0.145). The mean pain score during anesthetization with lidocaine prilocaine cream (intervention group) was significantly lower than with the intracervical injection (1.20 ± 0.29, 95%CI 0.60-1.80 vs. 3.62 ± 0.48, 95%CI 2.64-4.60, p < 0.001). No serious adverse events occurred.
Conclusion: Lidocaine prilocaine cream was not significantly different intracervical injection for pain relief during LEEP and provided better pain relief during anesthetization (than in the control group) without serious adverse events.
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