General gynaecology: Intrauterine lignocaine as an anaesthetic during endometrial sampling: a randomised double‐blind controlled trial

Hui, S. K.; Lee, L; Ong, Cliff K. S.; Yu, Victor L.; Ho, LC

doi:10.1111/j.1471-0528.2005.00812.x

Cited by 29 publications

(5 citation statements)

References 13 publications

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“…(Table 1) Four studies involved biopsy with a biopsy cannula,(15–18) two used biopsy with a vacuum aspirator,(19, 20) and two reported on curettage with a sharp Sims curette. (21, 22) All studies used a saline placebo comparator.…”

Section: Resultsmentioning

confidence: 99%

Intrauterine Anesthesia for Gynecologic Procedures

Mercier

Zerden

2012

Obstetrics & Gynecology

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Objective To assess the effectiveness of intrauterine local anesthesia in reducing pain associated with outpatient gynecologic procedures. Data Sources We searched online databases PubMed or MEDLINE, Embase, Google Scholar, and Clinicaltrials.gov, and hand-searched reference lists from reviews evaluating pain control methods for gynecologic office procedures. We identified randomized controlled trials using intrauterine local anesthetic in gynecologic procedures. Methods Titles and abstracts were screened for 1,236 articles. We identified 45 potential articles for inclusion. We excluded 22 of these studies because: 1) they were not randomized controlled trials; 2) they did not describe a quantifiable dose of medication used in the study; 3) they did not investigate an intrauterine anesthetic; 4) they did not study a potentially awake, outpatient procedure; and 5) they did not clearly report results or represented duplicate publication. Twenty-three articles were ultimately included for review. Tabulation, Integration, and Results Two authors independently reviewed full search results and assessed eligibility for inclusion, and independently abstracted data from all articles that met criteria for inclusion. Disagreements regarding eligibility or abstraction data were adjudicated by a third independent person. Our primary endpoint was reported effect of intrauterine local anesthesia on patient-reported pain scores. Due to heterogeneity in study methods, outcome measures, and reporting of outcomes, results could not be combined in a meta-analysis. Good evidence supports use of intrauterine anesthesia in endometrial biopsy and curettage, as five good-quality studies reported reduced pain scores while only one good-quality study reported negative results. We found moderate evidence to support intrauterine anesthesia in hysteroscopy, as one good-quality study and two fair or poor quality studies reported reduced pain scores, while two good-quality studies had negative results. Good evidence suggests that intrauterine anesthesia is not effective in hysterosalpingography; three good-quality studies reported that pain scores were not reduced, and no good quality studies showed beneficial effect in that procedure. Evidence was insufficient concerning first-trimester abortion, saline-infusion sonogram, tubal sterilization, and intrauterine device insertion. Conclusion Intrauterine local anesthesia can reduce pain in several gynecologic procedures including endometrial biopsy, curettage, and hysteroscopy, and may be effective in other procedures as well.

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Section: Resultsmentioning

confidence: 99%

Intrauterine Anesthesia for Gynecologic Procedures

Mercier

Zerden

2012

Obstetrics & Gynecology

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“…Although the Pipelle procedure is more comfortable than dilation and curettage, patients may still suffer from discomfort and pain. Several pain-reduction methods have been evaluated in the literature; for example, intrauterine anesthesia, intrauterine anesthesia plus a nonsteroidal anti-inflammatory drug (NSAID), topical analgesia, intrauterine anesthesia plus buccal misoprostol, and transcutaneous electrical nerve stimulation have been tested [5,6,7,8,9,10,11]. The local benzocaine study was the only study that did not demonstrate pain reduction [7].…”

Section: Introductionmentioning

confidence: 99%

Vaginal Misoprostol versus a Rectal Nonsteroidal Anti-Inflammatory Drug to Reduce Pain during Pipelle Endometrial Biopsies: A Prospective, Randomized, Placebo-Controlled Trial

Telli

Aydın²,

Öge

et al. 2014

Gynecol Obstet Invest

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Background: To evaluate and compare the efficacy of vaginal misoprostol and a rectal nonsteroidal anti-inflammatory drug (NSAID) on pain relief during Pipelle endometrial biopsies in a placebo-controlled randomized study. Methods: One hundred and fifty-one women who had an indication for a Pipelle endometrial biopsy were randomized into three groups as follows: group 1, vaginal misoprostol; group 2, rectal NSAID, and group 3, control. After the procedure, the women were asked to record their pain severity on a visual analog scale. The secondary outcome of the study was patient acceptability, and vasovagal symptoms and analgesic requirements after the procedure were also recorded. Results: There were no statistically significant differences in the demographic characteristics of the patients. The primary study outcome was the comparison of the median visual analog scale pain scores of groups 1 and 2 versus group 3 (controls); no statistically significant differences were found (p = 0.502). In addition, the patient acceptability (Likert scale), vasovagal symptoms and analgesic requirements after the procedure were similar among the groups (p = 0.204, 1 and 0.546, respectively). Conclusion: Our study did not demonstrate a reduction in pain relief during Pipelle endometrial biopsies for patients receiving vaginal misoprostol or a rectal NSAID when compared to patients receiving placebo treatment.

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“…Hui et al ., randomized, double-blind, placebo-controlled trial found the intrauterine instillation of lignocaine reduced pain during endometrial sampling. [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

Intrauterine Levobupivacaine Instillation for Pain Control in Women Undergoing Diagnostic Hysteroscopy

Abdelazim¹,

El-Ghazaly²,

Elshabrawy³

2022

Gynecology and Minimally Invasive Therapy

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Objectives: Many women experience pain and discomfort after hysteroscopic procedure. Pain and discomfort after hysteroscopic procedures can be explained by the cervical dilatation, intrauterine manipulation, and/or hydrodistension. This study designed to evaluate the efficacy of intrauterine levobupivacaine instillation for pain control in women undergoing diagnostic hysteroscopy. Materials and Methods: One hundred and twenty (120) women scheduled for diagnostic hysteroscopy and endometrial biopsy due to uterine bleeding were included in this study and randomized either to levobupivacaine group or controls. At the end of hysteroscopy, 5 mL of 0.5% levobupivacaine was instilled intrauterine in levobupivacaine group, while 5 mL of 0.9% saline was instilled intrauterine in controls. Participants were kept in the hospital for 12 h after diagnostic hysteroscopy to detect the postoperative (PO) pain intensity using visual analog scale (VAS), and PO required analgesics. Results: The VAS was significantly lower in levobupivacaine group compared to controls 3 h. PO (1.31 ± 1.02 vs. 1.62 ± 0.76, respectively), ( P = 0.01), 6 h. PO (0.81 ± 1.24 vs. 1.53 ± 0.88, respectively), ( P = 0.004), and 9 h. PO (0.55 ± 1.25 vs. 1.12 ± 0.95, respectively), ( P = 0.01). The total PO required analgesics were significantly lower in levobupivacaine group compared to controls ( P = 0.005). Conclusion: The intrauterine levobupivacaine instillation was simple, and effective for pain relief after diagnostic hysteroscopy, it significantly decreased pain score assessed by VAS at 3, 6, and 9 h., PO, and it significantly decreased PO required analgesics.

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General gynaecology: Intrauterine lignocaine as an anaesthetic during endometrial sampling: a randomised double‐blind controlled trial

Cited by 29 publications

References 13 publications

Intrauterine Anesthesia for Gynecologic Procedures

Intrauterine Anesthesia for Gynecologic Procedures

Vaginal Misoprostol versus a Rectal Nonsteroidal Anti-Inflammatory Drug to Reduce Pain during Pipelle Endometrial Biopsies: A Prospective, Randomized, Placebo-Controlled Trial

Intrauterine Levobupivacaine Instillation for Pain Control in Women Undergoing Diagnostic Hysteroscopy

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