title: Comparison of level of pain between using manual vacuum aspiration and sharp curettage in management of abnormal uterine bleeding.
abstract: OBJECTIVE
  To compare the level of pain between using manual vacuum aspiration and sharp curettage in the patients who had abnormal uterine bleeding that underwent uterine curettage under paracervical block with analgesics.
  
  
  METHODS
  Randomized controlled trial study.
  
  
  METHODS
  Between September 2009 to June 2010, 48 women with abnormal uterine bleeding who need to undergone uterine curettage were asked to join the present study and informed consents were signed. Twenty four women were randomly assigned into manual vacuum aspiration (MVA) group and other 24 women into sharp curettage group. The main outcome was the difference of the level of pain before, during and after procedure measured by using the visual analog scale and categorical pain scores. Fisher exact, Student t test and Mann-Whitney U test were used for statistical analysis.
  
  
  RESULTS
  The median visual analog score during MVA-procedure was significantly lower than the median visual analog score during in sharp curettage (median visual analog pain scores (interquartile range) 80 (30-100) vs. 45 (0-80); p < 0.01)). And the median score immediately after procedure in the MVA group was also significantly lower than in the sharp curettage group (median visual analog pain scores (interquartile range) 45 (0-80 vs. 25 (0-70); p = 0.02). The categorical pain score in the MVA group during procedure and immediately after procedure were also significantly lower than in the sharp curettage group. (No pain to mild pain vs. moderated to severe pain; p = 0.03, immediately after procedure: no pain to mild pain vs. moderated to severe pain; p = 0.01).
  
  
  CONCLUSIONS
  The level of pain in the patients who underwent uterine curettage by using MVA was lower than using sharp curettage. The using MVA may reduce pain compared to sharp curettage. However, more sample size research should be conducted to determine this significant.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand. doctor_artit@yahoo.co.th
authors.forename: Arthit
authors.initials: A
authors.lastname: Boonyarangkul
authors.forename: Orawan
authors.initials: O
authors.lastname: Leksakulchai
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000773:Anesthesia, Obstetrical; D005260:Female; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D014592:Uterine Hemorrhage / Q000601:surgery*; D014619:Vacuum Curettage / Q000009:adverse effects* / Q000295:instrumentation
chemical_list: D000700:Analgesics