In-office thermachoice III ablation: a comparison of two anesthetic techniques.
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.
Chapa
Hector O
HO
Women's Specialty Center, 1135 N Bishop Ave., Dallas, TX 75208, USA. ChapaMD@aol.com
Venegas
Gonzalo
G
VanDuyne
Charles P
CP
Suvunrungsi
Luke
L
Antonetti
Alfred G
AG
Sandate
Jeffrey
J
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
D000701:Analgesics, Opioid; D005283:Fentanyl