The use of topical anesthesia in diagnostic hysteroscopy and endometrial biopsy

Zupi, Errico; Luciano, Anthony A.; Marconi, Daniela; Valli, E; Patrizi, G.; Romaninï, Carlo

doi:10.1016/s1074-3804(05)81018-7

Cited by 49 publications

(76 citation statements)

References 4 publications

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“…Although these studies are different from ours in terms of material and method, they are significant as they showed that intrauterine anesthesia decreased pain in many gynecologic procedures. A limited number of studies on intrauterine topical anesthesia is available in literature and in most of these studies, the effectiveness of intrauterine anesthesia was investigated either in hysteroscopy or in hysteroscopy combined with endometrial biopsy (5,(8)(9)(10)17). Endometrial biopsy taken during hysteroscopy is more invasive and potentially more disturbing than only endometrial biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have investigated the use of local anesthetics (i.e., lidocaine, mepivacaine) to lessen the pain experienced during minor gynecological procedures such as endometrial biopsy and office hysteroscopy. Most, but not all, of these studies reported reduced pain during the procedure (8)(9)(10). The main objective of the present study was to compare the effectiveness of paracervical block, intrauterine lidocaine and oral etodolac in decreasing pain caused by endometrial sampling.…”

Section: Sonuçmentioning

confidence: 94%

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Comparison of the efficacy of intrauterine lidocaine, paracervical block and oral etodolac for decreasing pain in endometrial biopsy

Güler¹,

Şahin²,

Kucukaydin³

et al. 2010

J Turkish German Gynecol Assoc

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Objective:To compare the effectiveness of paracervical block, intrauterine lidocaine and oral etodolac in decreasing the pain caused by pipelle endometrial sampling. A secondary goal of this study was to determine the adverse effects and compare possible effects of these methods on pulse and blood pressure. Material and Methods:The study was performed between April 2006 and October 2006 in the Obstetrics and Gynecology Department of Van Yüzüncü Yıl University Research Hospital. One-hundred twenty patients were randomized into four groups: 1. Group: Paracervical block was performed with 3 ml 2% prilocaine solution. 2. Group: Five ml of 2% lidocaine solution was instilled through the endocervix into the uterine cavity. 3. Group: Subjects received 400 mg oral etodolac tablet 1-1.5 hour before the procedure. 4. Group: No method of anesthesia was used in the control group. Endometrial sampling was performed with pipelle. Severity of pain during the procedure was scored by the subjects according to the "6-point Verbal Rating Scale (VRS)". Blood pressure and pulse rate were measured before, during and 30 minutes after the procedure.Results: Pain scores in intrauterine lidocaine group (2 nd group) were found statistically significantly lower than the other three groups (p<0.05). Conclusion: Intrauterine lidocaine anesthesia technique decreasespain in endometrial sampling with pipelle more efficiently than paracervical block or oral etodolac. While indication of menorrhagia and endometrial thickness more than 5 mm increased pain scores, intrauterine lidocaine application or paracervical block decreased the scores significantly (p<0.05 Abstract Özet Original Investigation 178Endometrial sampling is a diagnostic tool that is frequently applied in outpatient clinics for many disorders, including abnormal uterine bleeding, abnormal cytology, postmenopausal bleeding, hormone therapy monitoring and infertility. Today, although sonographic evaluation of the endometrium is the first step, pathological examination is still "the gold standard" in the diagnostic pathway. Traditionally, the standard method of assessing the endometrium has been dilatation of the cervix and curettage (D&C) of the uterine cavity. Recently, simple, quick, safe and inexpensive methods such as Pipelle, Vabra and Z-sampler have superceded this technique. Pipelle is the most popular of these sampling devices (1, 2). Although pipelle is known to be painless or to cause less pain than conventional methods of endometrial sampling, nearly half of the patients experience moderate-to-severe pain during the procedure (3). Nevertheless, there are only a few studies that have evaluated possible methods of pain-relief during endometrial biopsy using a pipelle (4).

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Section: Discussionmentioning

confidence: 99%

Section: Sonuçmentioning

confidence: 94%

Comparison of the efficacy of intrauterine lidocaine, paracervical block and oral etodolac for decreasing pain in endometrial biopsy

Güler¹,

Şahin²,

Kucukaydin³

et al. 2010

J Turkish German Gynecol Assoc

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“…Moreover, increased incidence of symptomatic bradycardia and hypotension was noted and it was thought to be due to anaesthetic intravasation. A randomised controlled trial by Zupi et al 1 suggested that transcervical instillation of local anaesthetic agent into the uterine cavity could reduce pain in hysteroscopy and endometrial biopsy but the trial was small and the difference was not statistically significant. The anaesthetic agent was thought to act on the nerve endings within the endometrial mucosa.…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that the use of topical anaesthesia by instilling an anaesthetic agent into the uterine cavity may reduce the pain. 1,2 This study was carried out to evaluate whether intrauterine lignocaine is effective in reducing pain during the procedure.…”

Section: Introductionmentioning

confidence: 99%

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

Hui¹,

Lee²,

Ong³

et al. 2005

BJOG

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Objective To evaluate the effectiveness of intrauterine lignocaine as an anaesthetic during endometrial sampling.Design Prospective, randomised, double-blind, placebo-controlled trial.Setting Outpatient gynaecological minor operation unit in a public hospital.Population Two hundred premenopausal women scheduled for endometrial sampling because of abnormal uterine bleeding.Methods Transcervical intrauterine instillation of 5 mL of 2% lignocaine or 5 mL of normal saline before performing endometrial sampling with vacuum aspirator.Main outcome measures Evaluation of pain associated with the procedure using a visual analogue scale.Results The use of intrauterine lignocaine reduced pain during suction curettage in endometrial sampling.Conclusions Transcervical instillation of lignocaine reduced pain during endometrial sampling.

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“…During hysteroscopy, the most painful steps may occur during application of the tenaculum, dilatation of the cervix and distension of uterine cavity [11,12]. Also, the pain recorded is directly related to hysteroscopic diameter [13].…”

Section: Introductionmentioning

confidence: 99%

Three-year experience in outpatient microwave endometrial ablation

2004

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The objective was to assess the feasibility, acceptability, efficacy and safety of outpatient microwave endometrial ablation (MEA) under local anaesthesia in the treatment of therapy-resistant menorrhagia. This was carried out as a prospective observational study with a follow-up postal questionnaire at the Royal United Hospital Bath, NHS Trust, Bath, UK. For the study, 117 selected women fulfilled the selection criteria with a mean age of 42.4 years (range 29-53 years), referred because of uncontrolled menorrhagia. They were recruited between April 2000 and March 2003. Preoperative evaluation included history taking, physical examination and ultrasound scanning. Follow-up was by specially designed home postal questionnaire, which was mailed to all women 3 to 6 months after surgery. The acceptability of MEA under local anaesthesia, efficacy in changing the menstrual pattern and operative and postoperative complications were measured. For a total of 117 women, 116 procedures were successfully performed under local anaesthesia. One procedure was abandoned. There were no intraoperative or postoperative complications. The procedure was well tolerated. The menstrual satisfaction rate was 89.5%. The percentage of women reporting amenorrhoea was 41.2%. All other measures of pain were improved. Five women requested a repeat MEA, and 12 women underwent hysterectomy following MEA. In conclusion, MEA is a feasible, safe, easy and effective outpatient method of endometrial ablation in women suffering from therapy-resistant menorrhagia. Outpatient MEA is accepted and tolerated by patients. It has a place in current modern practice in treating menorrhagia.

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The use of topical anesthesia in diagnostic hysteroscopy and endometrial biopsy

Cited by 49 publications

References 4 publications

Comparison of the efficacy of intrauterine lidocaine, paracervical block and oral etodolac for decreasing pain in endometrial biopsy

Comparison of the efficacy of intrauterine lidocaine, paracervical block and oral etodolac for decreasing pain in endometrial biopsy

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

Three-year experience in outpatient microwave endometrial ablation

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