Effectiveness Of Paracervical Block In Comparison To Paracervical Block With Intrauterine Lignocaine As Analgesia For Uterine Curettage – A Randomized Clinical Study

Abstract

Background: Dilatation and curettage (D&C) is a commonly performed gynecological OPD procedures used for both diagnostic and therapeutic purposes which were earlier done in the OT. A major obstacle in completion of outpatient uterine curettage procedure is pain. Alleviation of pain is the most important part and for the same several different methods have been explored to improve the success rate.

Objectives: The aim is to study the effect of intrauterine lignocaine in addition to paracervical block compared to paracervical block as an analgesia during uterine curettage. It also aims to compare changes in non invasive blood pressure and pulse rate in both the groups, to compare the complications and side effects between the two groups and to assess the need for additional analgesia

Methods: This is a randomized control clinical study, done over a period of 18 months on 100 women on OPD basis in the Department of Obstetrics and Gynaecology. The study included 2 groups with 50 women in each group. Group 1 received paracervical block(PCB) and Group 2 received PCB with intrauterine lignociane instillation. D&C is carried out and pain scores are noted using VAS. Pulse rate, blood pressure, side effects, requirement of additional analgesia is compared between the two groups.

Results: The patients in both groups were well matched for age, parity, body mass index.At all three sages, pain perceived in group 2 was significantly less compared to group 1 (p<0.0001). The change in pulse rate and blood pressure were much less in the Group 2 compared to group 1.

Conclusion: The study offers promising insights into the benefits of adding Intra Uterine Lignocaine to Paracervical block, particularly in terms of pain management and patient comfort. Also, adding 2% intrauterine lignocaine to the paracervical block does not enhance the adverse effects, it is a safe and cost effective method. However, future research with larger sample sizes, longer follow-up periods, and more diverse populations is necessary to confirm.