Comparison between paracervical block and intrauterine lidocaine for pain management in surgical termination of first-trimester miscarriage: a randomized clinical trial
Background and aim Pain relief is a fundamental issue for women requiring gynecological procedures, including first-trimester evacuation. This study aimed to evaluate and compare the efficacy of paracervical block versus intrauterine lidocaine instillation versus combined paracervical block and intr...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-04-01
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| Series: | Al-Azhar Assiut Medical Journal |
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| Online Access: | https://journals.lww.com/10.4103/azmj.azmj_13_21 |
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| author | Doaa M. Effat Mona A. Elkafrawy Amira A.E. Shaban |
| author_facet | Doaa M. Effat Mona A. Elkafrawy Amira A.E. Shaban |
| author_sort | Doaa M. Effat |
| collection | DOAJ |
| description | Background and aim
Pain relief is a fundamental issue for women requiring gynecological procedures, including first-trimester evacuation.
This study aimed to evaluate and compare the efficacy of paracervical block versus intrauterine lidocaine instillation versus combined paracervical block and intrauterine lidocaine anesthesia as pain-relief methods during surgical termination of first-trimester miscarriage on perceived pain, satisfaction, side effects, and safety.
Patients and methods
One hundred fifty pregnant women suffering from first-trimester miscarriage and requiring pregnancy termination were randomly assigned into three equal groups. Group I (n=50), receiving paracervical block (10 ml of 2% of lidocaine 100 mg). Group II (n=50), received (10 ml of 2% lidocaine intrauterine). Group III received both of paracervical block and intrauterine lidocaine. Assessment of pain was measured for participants by numeric rating scale three times, intraoperative, immediately, after, and 30 min postoperative.
Results
There was a significant decrease of pain-perception level in women of group III compared with group I and group II. There was an insignificant difference in the frequency of adverse effects of drug like nausea, vomiting, drowsiness, and dizziness among the study groups. In terms of pain-relief satisfaction, there was adequate satisfaction in group III compared with other groups.
Conclusion
Injection of 2% lidocaine intrauterine in combination with standard paracervical block significantly provides adequate intraoperative and postoperative pain relief and satisfaction more than paracervical block or intrauterine lidocaine alone in the first-trimester surgical miscarriage. Also, this method is safe and effective. |
| format | Article |
| id | doaj-art-8dcca907b8684787af62d46e3e61f9e5 |
| institution | Kabale University |
| issn | 1687-1693 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Al-Azhar Assiut Medical Journal |
| spelling | doaj-art-8dcca907b8684787af62d46e3e61f9e52025-01-17T15:56:36ZengWolters Kluwer Medknow PublicationsAl-Azhar Assiut Medical Journal1687-16932024-04-01222636910.4103/azmj.azmj_13_21Comparison between paracervical block and intrauterine lidocaine for pain management in surgical termination of first-trimester miscarriage: a randomized clinical trialDoaa M. EffatMona A. ElkafrawyAmira A.E. ShabanBackground and aim Pain relief is a fundamental issue for women requiring gynecological procedures, including first-trimester evacuation. This study aimed to evaluate and compare the efficacy of paracervical block versus intrauterine lidocaine instillation versus combined paracervical block and intrauterine lidocaine anesthesia as pain-relief methods during surgical termination of first-trimester miscarriage on perceived pain, satisfaction, side effects, and safety. Patients and methods One hundred fifty pregnant women suffering from first-trimester miscarriage and requiring pregnancy termination were randomly assigned into three equal groups. Group I (n=50), receiving paracervical block (10 ml of 2% of lidocaine 100 mg). Group II (n=50), received (10 ml of 2% lidocaine intrauterine). Group III received both of paracervical block and intrauterine lidocaine. Assessment of pain was measured for participants by numeric rating scale three times, intraoperative, immediately, after, and 30 min postoperative. Results There was a significant decrease of pain-perception level in women of group III compared with group I and group II. There was an insignificant difference in the frequency of adverse effects of drug like nausea, vomiting, drowsiness, and dizziness among the study groups. In terms of pain-relief satisfaction, there was adequate satisfaction in group III compared with other groups. Conclusion Injection of 2% lidocaine intrauterine in combination with standard paracervical block significantly provides adequate intraoperative and postoperative pain relief and satisfaction more than paracervical block or intrauterine lidocaine alone in the first-trimester surgical miscarriage. Also, this method is safe and effective.https://journals.lww.com/10.4103/azmj.azmj_13_21first-trimester surgical abortionintrauterine lignocainenumeric rating scaleparacervical block |
| spellingShingle | Doaa M. Effat Mona A. Elkafrawy Amira A.E. Shaban Comparison between paracervical block and intrauterine lidocaine for pain management in surgical termination of first-trimester miscarriage: a randomized clinical trial Al-Azhar Assiut Medical Journal first-trimester surgical abortion intrauterine lignocaine numeric rating scale paracervical block |
| title | Comparison between paracervical block and intrauterine lidocaine for pain management in surgical termination of first-trimester miscarriage: a randomized clinical trial |
| title_full | Comparison between paracervical block and intrauterine lidocaine for pain management in surgical termination of first-trimester miscarriage: a randomized clinical trial |
| title_fullStr | Comparison between paracervical block and intrauterine lidocaine for pain management in surgical termination of first-trimester miscarriage: a randomized clinical trial |
| title_full_unstemmed | Comparison between paracervical block and intrauterine lidocaine for pain management in surgical termination of first-trimester miscarriage: a randomized clinical trial |
| title_short | Comparison between paracervical block and intrauterine lidocaine for pain management in surgical termination of first-trimester miscarriage: a randomized clinical trial |
| title_sort | comparison between paracervical block and intrauterine lidocaine for pain management in surgical termination of first trimester miscarriage a randomized clinical trial |
| topic | first-trimester surgical abortion intrauterine lignocaine numeric rating scale paracervical block |
| url | https://journals.lww.com/10.4103/azmj.azmj_13_21 |
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