title: Intrauterine lidocaine infusion for pain relief during saline solution infusion sonohysterography: a randomized, controlled trial.
abstract: OBJECTIVE
  To evaluate the efficacy of intrauterine lidocaine instillation in reducing patient discomfort during saline solution infusion sonohysterography (SIS).
  
  
  METHODS
  A double-blinded, randomized, controlled trial (Canadian Task Force classification I).
  
  
  METHODS
  Suleyman Demirel University School of Medicine, Department of Obstetrics and Gynecology, Isparta.
  
  
  METHODS
  One hundred-six women who underwent SIS.
  
  
  METHODS
  Fifty-three patients were allocated to the lidocaine group and 53 to the saline solution group.
  
  
  RESULTS
  The main outcome measures were the intensity of pain during, immediately after, and 20 minutes after the procedure, assessed by a visual analog scale and the patients' distress evaluated by the physician with a 3-point observer scale. There were no statistically significant differences between the study group and the control group in mean age, parity, past cervical surgery, history of chronic pelvic pain and dysmenorrhea, history of curettage, education, socioeconomic status, menopausal status, volume of saline solution infused (mL), tenaculum use, and indication for SIS. Pain scores demonstrated a statistically significant difference between groups during the procedure (placebo 5.09 +/- 1.25 [95% CI 4.74-5.43], lidocaine 3.90 +/- 1.02 [95% CI 3.61-4.18], p <.001); immediately after procedure (placebo 4.03 +/- 0.89 [95% CI 3.78-4.27], lidocaine 3.16 +/- 0.67 [95% CI 2.97-3.34], p <.001); and 20 minutes after procedure (placebo 3.32 +/- 0.54 [95% CI 3.17-3.46], lidocaine 2.43 +/- 0.72 [95% CI 2.23-2.62], p <.001). No significant pain relief in nulliparous patients was obtained by the use of lidocaine (4.88 +/- 1.01 [95% CI 4.60-5.15], 3.88 +/- 0.86 [95% CI 3.64-4.11], 3.22 +/- 0.55 [95% CI 3.06-3.37], respectively; p >.05). Pain rated by the physician during, immediately after, and 20 minutes after the procedure was significantly different between the groups (p <.001), and a significant correlation was noted between the visual analog pain score and the patients' distress recorded by the physician (r = 0.816, r = 0.697, r = 0.676; p <.001, respectively).
  
  
  CONCLUSIONS
  Intrauterine lidocaine seems to be effective in decreasing pain in parous women undergoing SIS.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey. mguney@med.sdu.edu.tr
authors.forename: Mehmet
authors.initials: M
authors.lastname: Guney
authors.forename: Baha
authors.initials: B
authors.lastname: Oral
authors.forename: Gokhan
authors.initials: G
authors.lastname: Bayhan
authors.forename: Tamer
authors.initials: T
authors.lastname: Mungan
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000009:adverse effects*; D007263:Infusions, Parenteral; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D014591:Uterine Diseases / Q000000981:diagnostic imaging
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine