Pain relief during hysterosalpingography: role of intracervical block

Abstract

Intracervical block can be offered to all women undergoing HSG to make the procedure less painful and thus improve the compliance.

In-office transvaginal hydrolaparoscopy: a step-by-step, intraoperative pain evaluation

“…The main discomfort during this procedure is during the dye injection due to the stretching of the Fallopian tubes. A recent study [17] evaluated the pain during the different phases of HSG using a VAS scale and they found that the most painful step was dye injection with a mean pain VAS score of 5.12 ± 1.45. This value seems to be quite similar to the result found in this study during the chromopertubation of THL.…”

Intracervical block compared with intramuscular sedation for dilatation and curettage

“…International Journal of Reproduction, Contraception, Obstetrics and Gynecology Volume 3 · Issue 1 Page 151 6 Hepburn S. in his study (Method of local anesthesia for IUD insertion) used intracervical block for all IUD insertions. The described technique is simple, low cost, requires no special equipment.…”

Confirmation test for hysteroscopic sterilization: a descriptive study of patient tolerability and impressions

“…[3][4][5][6] Other researchers have published their experience and proposed analgesia protocols during hysterosalpinography for infertility. [7][8][9] Traditionally, hysterosalpinography for infertility is done under high dye pressure instillation in an attempt to overcome proximal ostial spasm and/or mucus plugs, so hysterosalpinography (HSG) for infertility may be accompanied by pain. 8 In a randomized prospective study, Zhu et al evaluated the effect of warm (37 degrees) versus cold contrast media during hysterosalpinography for infertility in an attempt to reduce reflex tubal/uterine spasm.…”

“…8 Chauhan et al similarly attempted to reduce the pain associated with hysterosalpinography for infertility by using an intracervical anesthetic block. 9 Their prospective randomized study divided patients using a computer-generated table into two groups of 50 women each. In the study group, women received an intracervical block along with their premedication, whereas the controls received premedication alone.…”

“…Pain remained at a statistically lower level during the most painful steps, ie, traction of the cervix and insertion of dye (P = 0.001) in the study group as compared with the control group. 9 Information gathered from such reports may be helpful outside of hysterosalpinography for infertility. For example, our group's protocol for hysteroscopic sterilization performed in the office includes instillation of slightly warmed saline into the cavity as well as paracervical block analgesia (1% mepivacaine 30 mL diluted in 20 mL of normal saline).…”