A double blind randomized placebo-controlled trial to compare the effectiveness of paracervical block plus intrauterine anesthesia and paracervical block alone for pain relief during fractional curettage

Abstract

Background: Paracervical block (PCB) can reduce pain during fractional curettage (F/C) to moderate degree. Attempt should be made to further reduce pain intensity. Objective: To compare the effectiveness of PCB plus intrauterine anesthesia (IUA) and PCB alone for pain relief during F/C. Study design: A double blind randomized placebo-controlled trial. Materials and Methods: Fifty-two patients with abnormal uterine bleeding undergoing F/C in the Faculty of Medicine Siriraj Hospital were randomized to control group (n=27) receiving PCB alone, or treatment group (n=25) receiving PCB plus IUA. Outcome measured: Pain intensity during F/C measured by 10-cm Visual Analogue Scale (VAS). Results: The median value of pain score in the treatment group (2.3 cm) was significantly lower than that of the control group (4.7 cm), P = 0.033. There was no difference in patient satisfaction index or incidence of adverse events between the 2 groups. Conclusion: PCB plus IUA can reduce pain during F/C to mild degree which is better than PCB alone. PCB plus IUA may be an alternative for pain relief method during F/C.