Combined Intrauterine Lignocaine Injection and Paracervical Block Gives More Pain Relief Than Either Method Alone in Dilatation and Curettage Procedure

Sabry, Mohammed Ismail; Masoud, Alaa; Khedr, Israa; Elshamy, Elsayed

doi:10.21608/ejhm.2023.279023

Combined Intrauterine Lignocaine Injection and Paracervical Block Gives More Pain Relief Than Either Method Alone in Dilatation and Curettage Procedure

Authors

¹ 1Department of Obstetrics and Gynecology, Menoufia University Hospital, Menoufia, Egypt.

² 2Department of Obstetrics and Gynecology, Quesna Central Hospital, Menoufia, Egypt

³ 3Department of Obstetrics and Gynecology, King Abdul-Aziz airbase Hospital, Dhuhran, Saudi Arabia

10.21608/ejhm.2023.279023

Abstract

Background: Endometrial samples are typically obtained by the gynecological procedure known as dilatation and curettage (D & C). Anesthesia is required for the surgery. Although paracervical blocks are frequently employed, the pain they cause is mild to moderate.
Objective: The aim of this study was to compare the efficacy of intrauterine instillation of lidocaine, paracervical block, and a combination of the two procedures for their ability to control intra- and post-operative pain during and after endometrial curettage.
Patients and Methods: This research was conducted in Ob/Gyn Departments of Menoufia University Hospital and Quesna Central Hospital. 90 women were scheduled for endometrial curettage were divided into three equal groups by random selection: Group 1 (n=30): Lidocaine 2% was administered intra-uterine. Group 2 (n=30): Received paracervical blockage. Group 3 (n=30): Received combined intrauterine lidocaine and paracervical block.
Results: The current study showed that mean VAS value of D and C time was statistically higher among lidocaine (4.9 ± 0.76) than in combined intrauterine lidocaine and paracervical block (3.93 ± 0.83). Mean VAS value of D and C time was statistically higher among paracervical block (4.6 ± 1.13) than in combined intrauterine lidocaine and paracervical block (3.93 ± 0.83). Five minutes after the procedure, pain was least after the combined technique (group 3) then after intrauterine lidocaine group (group 1) then after paracervical block (group 2), (VAS:2.6 ± 0.93, 2.9 ± 0.9 and 3.67 ± 0.96 respectively). Conclusion: Greater analgesia was provided by using intrauterine lidocaine in combination with paracervical block than by using either lidocaine or paracervical block alone.