Transcervical intrauterine bupivacaine for the management of postoperative pain following endometrial balloon ablation—a pre-trial toxicity study

Bhatia, Kalsang; Rustimov, Oybek; Adhikary, Manju; Hill, Susan

doi:10.1007/s10397-008-0445-3

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…It is likely that the speculum insertion measurement is a surrogate for a patient's overall tolerance of pain and/or anxiety. Pain with speculum insertion occurs in many conditions such as dyspareunia, vulvar vestibular syndrome, and vaginismus (21,22). To control for possible confounding as the result of a nonequal distribution of women with insertional pain, we excluded those subjects who experienced pain from speculum insertion.…”

Section: Endometrial Biopsy Resultsmentioning

confidence: 99%

Transcervical intrauterine levobupivacaine infusion or paracervical block for pain control during endometrial biopsy

Köşüş

Güler

et al. 2012

Experimental and Therapeutic Medicine

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The aim of this study was to determine pain during endometrial biopsy by comparing the use of intrauterine instillation of levobupivacaine or paracervical block with a placebo in a randomized, double-masked trial in premenopausal and postmenopausal women. A total of 90 women were enrolled in the study. Patients were allocated to either the control or case groups. Group 1 consisted of 30 cases with intrauterine anesthesia with 5 ml 0.5% levobupivacaine. Group 2 consisted of 30 patients who underwent paracervical block with lidocaine. No analgesic agent was given to the remaining 30 patients; these cases comprised the control group. The primary outcome measures were pain or discomfort experienced during the procedure. When the pain scores of the different groups were compared, the scores in the intrauterine levobupivacaine and paracervical block groups were found to be significantly lower compared to those in the control group. There was no difference between the levobupivacaine and paracervical block groups in terms of pain scores. There was a marked positive correlation between biopsy indications and pain scores. Pain scores were lower in cases with the indication of polymenorrhea, hypermenorrhea and metrorraghia compared to those in the cases with other indications. In conclusion, the transcervical intrauterine instillation of levobupivacaine or paracervical block with lidocaine brings about pain relief during and after endometrial biopsy.

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Section: Endometrial Biopsy Resultsmentioning

confidence: 99%

Transcervical intrauterine levobupivacaine infusion or paracervical block for pain control during endometrial biopsy

Köşüş

Güler

et al. 2012

Experimental and Therapeutic Medicine

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“…According to our MEDLINE search, the present study was the first to evaluate efficacy of intrauterine topical levobupivacaine instillation for endometrial biopsy. We could find only one study (22) investigating the application of transcervical intrauterine bupivacaine for the management of postoperative pain following endometrial balloon ablation. They used dilute bupivacaine solution for prevention of severe postoperative pain after balloon ablation in 10 consecutive women; it was found to be effective with no side effects (22).…”

Section: Discussionmentioning

confidence: 99%

Transcervical Intrauterine Levobupivacaine or Lidocaine Infusion for Pain Control during Endometrial Biopsy

Köşüş¹,

Köşüş²,

Demircioğlu³

et al. 2014

Pain Research and Management

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Transcervical intrauterine topical instillation of levobupivacaine or lidocaine causes pain relief during endometrial biopsy. However, further studies are needed to evaluate the effectiveness of intrauterine anesthesia, to determine optimal concentration, volume and waiting time according to the type of local anesthetic agent, and to assess the applicability of the method to other intrauterine procedures.

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“…Bhatia et al ., a pilot study found the intrauterine instillation of dilute bupivacaine (125 mg) was safe, feasible, and effective for PO pain relief after endometrial balloon ablation procedure. [ 17 ]…”

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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Transcervical intrauterine bupivacaine for the management of postoperative pain following endometrial balloon ablation—a pre-trial toxicity study

Cited by 3 publications

References 11 publications

Transcervical intrauterine levobupivacaine infusion or paracervical block for pain control during endometrial biopsy

Transcervical intrauterine levobupivacaine infusion or paracervical block for pain control during endometrial biopsy

Transcervical Intrauterine Levobupivacaine or Lidocaine Infusion for Pain Control during Endometrial Biopsy

Intrauterine Levobupivacaine Instillation for Pain Control in Women Undergoing Diagnostic Hysteroscopy

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