The relationship between pain and uterine contractions during laser vaporization of the cervix.
Laser vaporization of the uterine cervix to treat cervical dysplasia is usually described by patients as moderately painful. Many describe the pain as uterine cramping, but most authorities attribute the pain to heat buildup during the procedure. To specify the mechanism of pain, intrauterine pressures were measured in 16 subjects (randomly divided into placebo and control groups of eight each) before and during cervical laser vaporization for dysplasia. The women were told what to expect during intrauterine pressure recording and laser vaporization and that a study of pain medication during laser vaporization was being conducted. The session began with 5 minutes of baseline intrauterine pressure recording. Subjects were then randomly given oral placebo or ibuprofen, 600 mg. Thirty to 45 minutes later, the intrauterine catheter was reinserted and the pressure recorded during 5 minutes of cervical laser vaporization. Laser vaporization increased significantly the frequency (P less than .025) and amplitude (P less than .03) of contractions in the placebo group but not in subjects given ibuprofen. However, post-procedure pain questionnaires showed no difference in pain perception between the groups. This study shows that pain during laser vaporization of the cervix is not due to increased uterine contractions, and that pain was not significantly relieved by ibuprofen.
Julian
T M
TM
Department of Obstetrics and Gynecology, University of Wisconsin, Madison.
O'Connell
B J
BJ
Gosewehr
J A
JA
D002584:Cervix Uteri / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D053685:Laser Therapy / Q000009:adverse effects; D010146:Pain / Q000209:etiology* / Q000517:prevention & control; D010147:Pain Measurement; D011292:Premedication; D002578:Uterine Cervical Dysplasia / Q000601:surgery; D014590:Uterine Contraction / Q000187:drug effects
D007052:Ibuprofen