Effects of Local Lidocaine Spray with Intravenous Meperidine for Pain Relief during Manual Vacuum Aspiration: A Double-Blinded Placebo Controlled Trial
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Abstract
Objective: To evaluate the efficacy of local cervical lidocaine spray with intravenous Meperidine for pain relief during the Manual Vacuum Aspiration (MVA) procedure compared to a local placebo spray with intravenous Meperidine.
Materials and Methods: A randomized, double-blinded, placebo-controlled trial was conducted in a tertiary care center during December 2023 to August 2024. 216 patients who underwent the MVA procedure and met the inclusion criteria participated in the trial, with 108 randomly assigned to the 10% lidocaine spray group and another 108 to the placebo group. A pharmacist prepared the packaging of topical spray for both groups to be identical. The intravenous analgesic agents used for pain relief were the same in both groups. The primary outcome was to compare pain scores using the visual analog scale (VAS) during MVA between groups. The secondary outcome was to evaluate the side effects of the local lidocaine spray.
Result: The baseline characteristics were not different in both groups. The mean immediately post MVA pain score in the lidocaine spray group was significant less than the placebo group (1.62 + 2.10 and 2.37 ± 2.43 respectively; mean difference 0.75; 95% CI 0.13 to1.36, p =0.016). However, there was no significant difference in pain score at the time before the operation, during the tenaculum application, during the MVA procedure, and 30 minutes post-MVA between two groups. There were no serious side effects in both groups.
Conclusion: Lidocaine spray can effectively reduce the pain at immediately post MVA without any serious side effects. It can be used as the additional therapy for pain reducing in the MVA procedure.
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