Paracervical compared with intracervical lidocaine for suction curettage: a randomized controlled trial.
OBJECTIVE
To estimate the efficacy of paracervical compared with intracervical administration of local anesthesia during first-trimester suction curettage.


METHODS
A double-blind, randomized controlled trial comparing paracervical with intracervical lidocaine was performed in women undergoing elective first-trimester suction curettage with conscious sedation. Pain was assessed at baseline, with dilation, and with curettage using a 10-cm visual analog scale (VAS). Assuming a minimal clinically important difference in pain score of 1.6 cm and a mean pain score (+/-standard deviation [SD]) of 4.7 (+/-2.9) cm for paracervical block, 120 patients would provide 80% power with an alpha of .05.


RESULTS
For the 132 women randomly assigned, no significant differences in VAS scores (mean+/-SD) were observed between paracervical and intracervical blocks during dilation (2.6+/-2.3 compared with 2.8+/-2.2, P=.72) or curettage (3.9+/-2.9 compared with 3.3+/-2.5, P=.16).


CONCLUSIONS
For women undergoing first-trimester suction curettage with conscious sedation, there was no clinically meaningful difference in pain relief between paracervical and intracervical lidocaine. Providers should feel confident that both techniques provide equally effective and acceptable analgesia.
Mankowski
Jennifer L
JL
From the Department of Reproductive Medicine, University of California, San Diego Medical Center, and First Avenue Family Planning-Michelle Wagner Center, Planned Parenthood, San Diego, California.
Kingston
Jessica
J
Moran
Thomas
T
Nager
Charles W
CW
Lukacz
Emily S
ES
D000028:Abortion, Induced / Q000009:adverse effects*; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001340:Autonomic Nerve Block / Q000379:methods*; D002584:Cervix Uteri; D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage*; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D014619:Vacuum Curettage / Q000009:adverse effects*; D055815:Young Adult
D000779:Anesthetics, Local; D008012:Lidocaine