title: A randomized, placebo-controlled, double-blind study of hysteroscopic-guided pertubal diluted bupivacaine infusion for endometriosis-associated chronic pelvic pain.
abstract: OBJECTIVE
  To assess the effectiveness of hysteroscopic-guided pertubal diluted bupivacaine infusion for endometriosis-associated chronic pelvic pain (CPP).
  
  
  METHODS
  Between June 2010 and July 2013, a randomized, placebo-controlled, double-blind study was undertaken at Mansoura University Hospital, Mansoura, Egypt. Patients meeting inclusion criteria (laparoscopically confirmed endometriosis, patent fallopian tubes, ≥6 months CPP, pain score on visual analogue scale [VAS] >5) were randomly assigned using a computer-generated randomization sequence to receive either office hysteroscopic-guided pertubal diluted bupivacaine infusion (0.25%) or placebo. Response to treatment was assessed using subjective data for scores on VAS and a monthly verbal rating scale (VRSmonthly) at baseline and at 1, 2, and 3 months of follow-up. Additionally, women completed a questionnaire to evaluate the overall satisfaction at 3 months.
  
  
  RESULTS
  Thirty patients were assigned to each group. In the bupivacaine group, VAS and VRSmonthly scores were significantly lower at 1, 2, and 3 months than at baseline (P<0.05 for all). Additionally, scores were significantly lower in the bupivacaine group than in the placebo group at 1, 2, and 3 months (P<0.05 for all). At 3 months, 22 (73%) women in the bupivacaine group expressed satisfaction, compared with 2 (7%) in the placebo group (P=0.18).
  
  
  CONCLUSIONS
  Office pertubal hysteroscopic-guided diluted bupivacaine infusion could be used to manage endometriosis-associated CPP for at least 3 months. AEARCTR-0000573.
authors.affiliation: Department of Obstetrics and Gynecology, Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt. Electronic address: tarek.shokeir@gmail.com.
authors.forename: Tarek
authors.initials: T
authors.lastname: Shokeir
authors.affiliation: Department of Anaesthesia and Intensive Care, Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt.
authors.forename: Sherif
authors.initials: S
authors.lastname: Mousa
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D059350:Chronic Pain / Q000188:drug therapy / Q000209:etiology; D004311:Double-Blind Method; D004534:Egypt; D004715:Endometriosis / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D010147:Pain Measurement; D017060:Patient Satisfaction; D017699:Pelvic Pain / Q000188:drug therapy* / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine
keywords: Bupivacaine; Endometriosis; Hysteroscopy; Pelvic pain