Paracervical Compared With Intracervical Lidocaine for Suction Curettage

Mankowski, Jennifer L.; Kingston, Jessica; Moran, Thomas J.; Nager, Charles W.; Lukacz, Emily S.

doi:10.1097/aog.0b013e31819ec97e

Cited by 28 publications

(16 citation statements)

References 14 publications

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“…18,19 In our study, Visual Analogue Scale was chosen due to its ease of use, and widely used in other studies. 12,20 Using opiods as the analgesia, most of our patients (90%) reported mild to moderate pain (score of 7 or less) during the procedure with the mean score of 4.5, comparable to a study using Meperidine (mean score 5.7; 59% reported mild to moderate pain). 8 Parenteral opiods especially intramuscular Pethidine was the preferred choice among our doctors due to extensive experience of its used in our centre for women in labour and for manual removal of placenta.…”

Section: Discussionsupporting

confidence: 76%

“…Paracervical or cervical block using Lignocaine 2%, following technique described by elsewhere, where were added if necessary, especially when cervical dilatation was needed. 12 The patients' demographic data and details of the MVA procedure were recorded in a prepared format, "Manual Vacuum Aspiration Assessment Format". The primary outcome of the analysis was to assess the efficacy of the procedure which is defined as complete uterine evacuation without the need for further intervention.…”

Section: Introductionmentioning

confidence: 99%

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Manual vacuum aspiration: a safe and effective surgical management of early pregnancy loss

Azman¹,

Sakri²,

Kusni³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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One of the most important aspect of surgical intervention is pain control, to ensure the procedure can be completed with minimal or no distress to the patients. Analgesia that had be used in MVA include oral, rectal or parenteral analgesia, intracervical analgesia, paracervical block, Entonox, oral and parenteral opiod or combination of these techniques. 5-11 All these methods had been shown to be effective in providing pain relieve during MVA, but the factors that may contribute to the pain sensation had not been adequately addressed. Here we are discussing the pain perception of our patients during MVA and the associated factor. ABSTRACTBackground: Manual vacuum aspiration (MVA) is an alternative to the standard sharp uterine curettage, performed under local anaesthetic or sedation in the daycare setting. The objectives of this study were to assess the efficacy and safety of MVA, the pain perception and the factors related to it. Methods: This was a prospective observational study of 58 consecutive patients who had undergone Manual Vacuum Aspiration (MVA) in Early Pregnancy Assessment Clinic, Hospital Kemaman between January and December 2017. Data on the patients' characteristics and the procedures were analysed. Results: The efficacy of the procedure was 96.5% (56/58) with no major complication recorded. Majority of the patients (91.3%) reported mild to moderate pain with 2/3 of them agreed to undergo MVA in the future and would recommend it to other patients. There was no significant difference in mean pain score between different groups of women (parity, education levels, occupations, previous uterine evacuation) or procedural techniques (analgesia, sedation, cervical block, cervical dilatation, procedure duration, number of aspiration passes). Conclusions: MVA is safe and well accepted procedure for out-patient surgical evacuation of early miscarriages.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Manual vacuum aspiration: a safe and effective surgical management of early pregnancy loss

Azman¹,

Sakri²,

Kusni³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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“…During cervical dilation, pain signals are carried by parasympathetic fibers that accompany the uterine vessels and cardinal ligament [12]. In addition to pain with cervical dilation, contraction or cramping pain is transmitted by sympathetic fibers from the ovarian plexus and inferior hypogastric nerve, which travels in the uterosacral ligament and inserts into the cervix at the 5 and 7 o'clock positions [7]. …”

Section: Discussionmentioning

confidence: 99%

“…Prior studies showed that paracervical block can be used as an anesthetic procedure for suction curettage [7]. Ovolabi evaluated and compared paracervical block with diclofenac for pain relief during suction curettage for surgical termination of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, paracervical injections may be best for preventing this cramping pain. Moreover prior studies showed that paracervical block can be used as an anesthetic procedure for suction curettage [7]. Lidocaine spray, which shows its effect by reduction of generation and conduction of peripheral pain impulses in dysfunctional or damaged nociceptors situated directly below the application site, is reported to produce significant pain relief even with the absence of clinically significant serum levels [8].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Paracetamol, Dexketoprofen Trometamol, Lidocaine Spray, and Paracervical Block Application for Pain Relief during Suction Termination of First-Trimester Pregnancy

Açmaz

Aksoy

Özoğlu

et al. 2013

BioMed Research International

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The aim of the study was to investigate the analgesic efficacy of preoperative oral dexketoprofen trometamol, intravenous paracetamol, lidocaine spray, and paracervical block with ultracaine on curettage procedure. A total of 111 subjects with the request of pregnancy termination between 5 and 7 weeks of gestation were included in the study. The first group (control group) consisted of 20 participants without medication. The second group consisted of 25 participants receiving 2 puffs of lidocaine sprays on cervical mucosa. The third group consisted of 20 participants receiving oral 25 mg dexketoprofen trometamol. The fourth group consisted of 23 participants receiving 1000 mg intravenous paracetamol and the fifth group consisted of 23 participants receiving paracervical block with ultracaine. Paracervical block reduced pain score significantly in both intraoperative and postoperative periods. All analgesic procedures were significantly effective for reducing pain in postoperative period. Paracervical block may be the best method for reducing pain scores in intraoperative and postoperative periods during curettage procedure. All analgesic procedures such as lidocaine, paracetamol, ultracaine, and paracervical block with ultracaine can be used for reducing pain score in postoperative period. This trial is registered with NCT01947205.

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