Intracervical Block and Pain Perception During the Performance of a Hysterosalpingogram

Robinson, Randal D.; Casablanca, Yovanni; Pagano, Katherine E.; Arthur, Nancy A.; Bates, G. Wright; Propst, Anthony M.

doi:10.1097/01.aog.0000247645.52211.41

Cited by 28 publications

(32 citation statements)

References 13 publications

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“…The concept of the MCSD was first explored by Todd et al 14 with regard to pain research and it has since been used as the target for clinical significance in analgesic efficacy studies 24,25 . This may now be the case for antiemetic efficacy studies, which have been difficult to compare in the past due to the variety of outcome measures that have been used 1–7 .…”

Section: Discussionmentioning

confidence: 99%

Use of the Visual Analog Scale to Rate and Monitor Severity of Nausea in the Emergency Department

Meek

Kelly

2009

Academic Emergency Medicine

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Objectives: The objective was to describe the association between verbal descriptors of nausea severity and visual analog scale (VAS) ratings in an undifferentiated emergency department (ED) population and to calculate the minimum clinically significant difference (MCSD) in VAS rating of nausea severity in this population.Methods: A prospective observational study was conducted at three EDs on a convenience sample of stable, consenting adult patients presenting with nausea as part of their symptom complex. Data included demographics, adjectival description of nausea severity (none, mild, moderate, or severe), and VAS rating (standard 100-mm line) at enrollment, 30 minutes, and 60 minutes. At 30 and 60 minutes they were also asked to describe any change in nausea severity from the previous rating (''a lot less,'' ''a little less,'' ''the same,'' ''a little more,'' ''a lot more''). The MCSD was defined as the average VAS change when a patient reported ''a little less'' or ''a little more'' nausea.Results: A total of 247 patients provided 693 matched adjectival ratings and VAS scores. Median age was 45 years, and 100 (40%) were male. The median VAS measures for none, mild, moderate, and severe nausea were 2, 23, 53, and 83 mm, respectively. VAS distributions in the verbal categories were statistically different from each other (Spearman rank correlation coefficient = 0.90; p < 0.0001). The MCSD was 22 mm (95% CI = 20 to 24 mm).Conclusions: There is very good correlation between verbal descriptors of nausea and VAS ratings. The MCSD for VAS nausea ratings in an ED population is 22 mm.

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Section: Discussionmentioning

confidence: 99%

Use of the Visual Analog Scale to Rate and Monitor Severity of Nausea in the Emergency Department

Meek

Kelly

2009

Academic Emergency Medicine

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“…(2003) concluded that lidocaine gel provided significant pain relief at the time of tenaculum placement. Subsequently, another report (Robinson et al ., 2007) showed that topical lidocaine-prilocaine cream significantly reduced pain at the time of cervical instrumentation, but not during uterine filling and tubal spillage, and another (Lorino et al ., 1990) demonstrated that application of 20% benzocaine gel provided significant pain relief. It should be noted that the previous studies were sometimes limited by unclear randomization, blinding and allocation methods.…”

Section: Discussionmentioning

confidence: 96%

“…Oral, intrauterine and topical analgesics have been evaluated for pain relief at HSG (Ahmad et al ., 2007; Ayida et al ., 1996; Cengiz et al ., 2006; Costello et al ., 2002; Costello et al ., 2005; Elson and Ridley, 2000; Frishman et al ., 2004; Kafali et al ., 2003; Liberty et al ., 2007; Lorino et al ., 1990; Owens et al ., 1985; Peters et al ., 1996; Robinson et al ., 2007). Application of 20% benzocaine gel to the cervix has been shown to provide significant relief during HSG in one study (Lorino et al ., 1990) while another suggested that application of lidocaine to the uterine cervix significantly reduces pain at the time of cervical instrumentation, but not during uterine filling and spillage (Robinson et al ., 2007).…”

Section: Introductionmentioning

confidence: 99%

“…Application of 20% benzocaine gel to the cervix has been shown to provide significant relief during HSG in one study (Lorino et al ., 1990) while another suggested that application of lidocaine to the uterine cervix significantly reduces pain at the time of cervical instrumentation, but not during uterine filling and spillage (Robinson et al ., 2007). However, interpretation of the current literature is limited by lack of blinding, placebo control, randomization and unclear allocation.…”

Section: Introductionmentioning

confidence: 99%

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Randomized controlled trial of benzocaine versus placebo spray for pain relief at hysterosalpingogram

Bachman

Senapati

Sammel

et al. 2014

Reproductive BioMedicine Online

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Many women experience pain during hysterosalpingogram (HSG). This prospective, randomized, double-blinded, placebo-controlled study assessed whether the use of benzocaine spray during HSG is associated with reduced pain as compared with placebo. Thirty women presenting for HSG were enrolled and randomized to either benzocaine or saline spray. Treatment groups were similar in age, race, parity, pre-procedure oral analgesic use and history of dysmenorrhoea and/or chronic pelvic pain. Median change in pain score from baseline to procedure was 50.6 mm (−7.4 to 98.8 mm) in the benzocaine group and 70.4 mm (19.8 to 100 mm) in the placebo group. There was no difference between groups after adjusting for history of dysmenorrhoea. There was no difference in resolution of pain in benzocaine versus placebo groups at 5 min post procedure – median pain score difference – 11.1 (−90.1 to 18.5) versus −37.0 (−100 to 1.2) – or at 30 min post procedure. Satisfaction scores did not differ by treatment and did not correlate with pain score during the procedure (rho = 0.005). The use of benzocaine spray does not significantly improve pain relief during HSG nor does it hasten resolution of pain post HSG. Of interest, patient satisfaction was not correlated with pain.

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“…But so what, if that well-defined pain is produced identically? Robinson et al 5 reported in a double-blind randomised controlled trial that hysterosalpingography subjects receiving a 1% lidocaine cervical block totalling 6 ml had significantly less pain ( p <0.001) measured by VAS from tenaculum placement, compared with a placebo intracervical saline injection group and a no-injection group. Another single-blind study, admittedly too recent for Bahamondes et al to cite, randomised 74 women.…”

mentioning

confidence: 99%

Comment on ‘Practical advice for avoidance of pain associated with insertion of intrauterine contraceptives’

Guillebaud

2014

J Fam Plann Reprod Health Care

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Intracervical Block and Pain Perception During the Performance of a Hysterosalpingogram

Abstract: I.

Cited by 28 publications

References 13 publications

Use of the Visual Analog Scale to Rate and Monitor Severity of Nausea in the Emergency Department

Use of the Visual Analog Scale to Rate and Monitor Severity of Nausea in the Emergency Department

Randomized controlled trial of benzocaine versus placebo spray for pain relief at hysterosalpingogram

Comment on ‘Practical advice for avoidance of pain associated with insertion of intrauterine contraceptives’

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