• Manee Rattanachaiyanont, Pichai Leerasiri, and Suchada Indhavivadhana.
• Gynecologic Endocrinology Unit, Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand. simrt@mahidol.ac.th
• Obstet Gynecol. 2005 Sep 1;106(3):533-9.

ObjectiveTo study the effectiveness of intrauterine anesthesia for pain relief during fractional curettage.MethodsA double-blinded, randomized, placebo-controlled trial was conducted in 66 patients with abnormal uterine bleeding undergoing fractional curettage under paracervical block, using 10-mL 1% lidocaine plus intrauterine 5-mL 2% lidocaine (n = 33) or saline (n = 33). The primary outcome was the maximum pain score measured with a 10-cm visual analog scale. Other outcomes measured included pain profile, number of patients with pain score more than 4, each patient's global satisfaction index, adverse events, and serum lidocaine profile.ResultsThe 2 groups were comparable in age, body mass index, education, socioeconomic status, menopausal status, and parity. Compared with the saline group, the lidocaine group had a significantly lower median value for the maximum pain score (2.3 versus 4.7, P = .022) and fewer patients with a pain score more than 4 (33.3% versus 60.6%, P = .026). The pain scores were lower at the endocervical curettage and the uterine curettage steps. There was no difference between the 2 groups in other outcomes. The number needed to treat to prevent a case with a pain score more than 4 was 3.7 (95% confidence interval 2.4-38.5).ConclusionThe addition of intrauterine anesthesia to paracervical block can further reduce pain during fractional curettage without increasing adverse effects.Level Of EvidenceI.

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