title: Analgesia for amniocentesis or chorionic villus sampling.
abstract: BACKGROUND
  Besides risks of miscarriage, pregnant women undergoing amniocentesis or chorionic villus sampling (CVS) are also concerned about pain associated with these procedures. Currently, approaches to analgesia can be categorised in two broad categories - non-pharmacological and pharmacological agents.
  
  
  OBJECTIVE
  To evaluate whether different methods of analgesia have any impact on pain reduction during amniocentesis or chorionic villus sampling (CVS).
  
  
  METHODS
  We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2011).
  
  
  METHODS
  All randomised trials comparing different method of analgesia for amniocentesis or CVS. We also include trials with quasi-randomised designs, but analyse and report their results separately.
  
  
  METHODS
  Both review authors assessed eligibility and trial quality and performed data extraction.
  
  
  RESULTS
  We included a total of five randomised studies (involving 805 women) evaluating different methods of analgesia for amniocentesis; there were no studies in women undergoing CVS.One RCT (N = 203) and one quasi-randomised study (N = 220) compared infiltrative local anaesthesia with no anaesthesia and found no statistical difference in experienced pain on the visual analogue scale (VAS) (mean differences (MD) -2.50 and 1.20; 95% confidence interval (CI) -6.98 to 1.98 and -2.67 to 5.07).One study (N = 200) compared light leg rubbing versus no intervention during amniocentesis and found no change in experienced anxiety (MD 0.2; 95% CI -0.63 to 1.03) or VAS pain score (MD 0.3; 95% CI -0.35 to 0.95) during amniocentesis.Another study with 62 patients did not find any benefit of using subfreezing temperature needle during amniocentesis in terms of decreased VAS pain score (MD -0.8; 95% CI -1.8 to 0.2). In addition, there was no difference between anticipated and actual pain (MD 0.4; 95% CI -0.82 to 1.62) (before/after comparison).There was also no difference in VAS pain scores in the study with 120 participants comparing lidocaine-prilocaine analgesic cream to placebo cream before amniocentesis (MD -0.6; 95% CI -1.44 to 0.24).
  
  
  CONCLUSIONS
  In general, women who undergo amniocentesis could be informed that pain during procedure is minor and that there is currently insufficient evidence to support the use of local anaesthetics, leg rubbing or subfreezing the needle for pain reduction during procedure.
authors.affiliation: University Clinical Department ofGynecology and Perinatology, University Clinical Center Maribor, Maribor, Slovenia.
authors.forename: Faris
authors.initials: F
authors.lastname: Mujezinovic
authors.forename: Zarko
authors.initials: Z
authors.lastname: Alfirevic
mesh_terms: D000649:Amniocentesis / Q000009:adverse effects*; D000698:Analgesia / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods; D015193:Chorionic Villi Sampling / Q000009:adverse effects*; D050785:Cryoanesthesia / Q000379:methods; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D010146:Pain / Q000517:prevention & control*; D011247:Pregnancy; D011318:Prilocaine / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic
chemical_list: D011318:Prilocaine; D008012:Lidocaine
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