Analgesic Efficacy of Forced Coughing versus Local Anesthesia during Cervical Punch Biopsy

Naki, Mehmet Murat; Api, Oluş; Acioglu, Hasniye Celik; Uzun, M Güray; Kars, Bülent; Ünal, Orhan

doi:10.1159/000320842

Cited by 29 publications

(31 citation statements)

References 42 publications

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“…Most patients can tolerate pain to complete necessary procedures but studies show that pain scores are often high.. Cervical biopsy and cervical curettage are associated with visual analogue scale (VAS) pain scores ranging from four to six on a 10-point scale. (1, 2) Endometrial biopsies done have VAS scores of five to seven(3, 4). Pain with intrauterine device (IUD )insertion varies from two to seven, (5–8) and pain scores during laminaria insertions with paracervical block range from five to seven.…”

Section: Introductionmentioning

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: Introductionmentioning

confidence: 99%

Intrauterine Anesthesia for Gynecologic Procedures

Mercier

Zerden

2012

Obstetrics & Gynecology

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“…The degree of pain associated with this procedure, as reported in published studies, varies from mild to severe . The effects of various anesthetic and analgesic approaches for pain relief during colposcopy and cervical biopsy have been examined in many studies . While the use of topical anesthetic gel and oral analgesic drugs appeared ineffective in this situation, it was evident that intracervical submucosal injection of lidocaine could reduce pain severity .…”

Section: Introductionmentioning

confidence: 99%

Effect of lidocaine spray during colposcopy‐directed cervical biopsy: A randomized controlled trial

Wongluecha

Tantipalakorn

Charoenkwan

et al. 2017

J of Obstet and Gynaecol

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“…Cervical biopsy and cervical curettage are associated with visual analog scale (VAS) pain scores ranging from four to six on a 10-point scale. 1,2 Endometrial biopsies have been reported to have VAS scores of five to seven. 3,4 Fractional curettage is a common procedure for investigating the causes of abnormal uterine bleeding in perimenopausal women.…”

Section: Introductionmentioning

confidence: 99%

Assessment of pain relief following intrauterine lignocaine in addition to paracervical block for fractional curettage

Meenambiga

Haribaskar

2016

Int J Reprod Contracept Obstet Gynecol

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Background: To assess the pain relief using visual analog score following intrauterine lignocaine in addition to paracervical block for fractional curettage. Methods: This study was a prospective, double blinded randomized controlled trial conducted in 168 patients in the department of obstetrics and Gynecology, Thanjavur Medical College with abnormal uterine bleeding. All patients received either intrauterine 2% lignocaine or Normal saline along with oral misoprostol 200μg and paracervical block prior to the procedure. The primary outcome was the assessment of pain perceived at the time of curette, soon after procedure (5 mins); 30 minutes later using VAS. Results: Both the groups were matched for age, parity, BMI, menopausal status, socioeconomic status and indication for the procedure. Patients in lignocaine group perceived less pain when compared to that in placebo group. There was no difference in both groups with respect to other outcomes. Conclusions: Addition of intrauterine 2% lignocaine in addition to paracervical block and oral misoprostol reduces pain making fractional curettage as a patient friendly procedure.

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Analgesic Efficacy of Forced Coughing versus Local Anesthesia during Cervical Punch Biopsy

Cited by 29 publications

References 42 publications

Intrauterine Anesthesia for Gynecologic Procedures

Intrauterine Anesthesia for Gynecologic Procedures

Effect of lidocaine spray during colposcopy‐directed cervical biopsy: A randomized controlled trial

Assessment of pain relief following intrauterine lignocaine in addition to paracervical block for fractional curettage

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