title: In-office thermachoice III ablation: a comparison of two anesthetic techniques.
abstract: BACKGROUND
  Patient comfort and safety are prerequisites for office procedures.
  
  
  OBJECTIVE
  comparison of the fentanyl transdermal patch with injection of local anesthesia for intraoperative/postoperative pain from in-office Thermachoice III ablations.
  
  
  METHODS
  Single-center prospective randomized (1:1) cohort study. Primary Endpoint: intraoperative and postoperative VAS pain scores (0 as no pain, 10 as extreme pain). Secondary Endpoints: patient satisfaction between cohorts and adverse events.
  
  
  RESULTS
  41 patients were randomized [21 patch protocol (FP), 20 injection protocol (IP)]. For patch users, the median VAS scores were 2.60 (range 1-4) intraoperatively and 3.30 (range 2-5) postoperatively (p = 0.09, CI = -0.8 to 0.4), with the most common adverse events being nausea (62%) and vomiting (38%). Compared to injection, there was no significant difference in intraoperative VAS score (FP median VAS = 2.60, IP median VAS = 2.59; p = 0.15, CI = -0.05 to 0.48), but a significant difference postoperatively (FP median VAS = 3.30, IP median VAS = 6.0; p = 0.01, CI = -2.6 to -1.4). Less NSAIDs were used postoperatively with the FP. At 24 h, more FP patients were 'very satisfied' or 'satisfied' than IP patients.
  
  
  CONCLUSIONS
  Patch intraoperative VAS pain scores are comparable to uterine block scores; postoperative VAS pain scores were statistically lower with the FP. FP resulted in more favorable 'satisfaction' rates compared to IP.
authors.affiliation: Women's Specialty Center, 1135 N Bishop Ave., Dallas, TX 75208, USA. ChapaMD@aol.com
authors.forename: Hector O
authors.initials: HO
authors.lastname: Chapa
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Venegas
authors.forename: Charles P
authors.initials: CP
authors.lastname: VanDuyne
authors.forename: Luke
authors.initials: L
authors.lastname: Suvunrungsi
authors.forename: Alfred G
authors.initials: AG
authors.lastname: Antonetti
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Sandate
mesh_terms: D000279:Administration, Cutaneous; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000772:Anesthesia, Local / Q000379:methods*; D015331:Cohort Studies; D055356:Endometrial Ablation Techniques / Q000379:methods*; D004717:Endometrium / Q000601:surgery*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D010146:Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl