title: Hysteroscopic local anesthetic intrauterine cornual block in office endometrial ablation: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the efficacy of a hysteroscopic local anesthetic intrauterine cornual block (ICOB) on pain experienced during office endometrial ablation (EA) in addition to a traditional direct local anesthetic cervical block (DCB).
  
  
  METHODS
  Prospective, randomized, double-blind, placebo-controlled trial.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Women with heavy menstrual bleeding scheduled for an office endometrial ablation.
  
  
  METHODS
  Before office EA, DCB plus hysteroscopic ICOB just medial to each tubal ostium using local anesthetic mixture made up of 1 mL 3% mepivacaine plus 1 mL 0.5% bupivacaine versus control group receiving DBC plus ICOB with 2 mL of placebo (saline).
  
  
  METHODS
  
  
  
  METHODS
  pain reported during procedure via visual analogue scale (VAS) from 0 to 10; secondary outcomes: postoperative pain, rescue analgesic requirement, and duration of hospital stay.
  
  
  RESULTS
  Most characteristics were similar across groups. The mean VAS score during the procedure was statistically significantly lower by 1.44 (95% confidence interval, -2.65 to -0.21) in the active group compared with the placebo group. There were no statistically significant differences between the two groups in the postprocedural mean VAS scores, rescue analgesic requirement, or duration of hospital stay.
  
  
  CONCLUSIONS
  Used in addition to DCB, ICOB reduces the pain experienced during office EA compared with DCB alone.
  
  
  BACKGROUND
  NCT01808898.
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
authors.forename: Vinod
authors.initials: V
authors.lastname: Kumar
authors.affiliation: University of Birmingham, Birmingham, United Kingdom.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tryposkiadis
authors.affiliation: Birmingham Women's NHS Foundation Trust, Birmingham, United Kingdom. Electronic address: j.k.gupta@bham.ac.uk.
authors.forename: Janesh Kumar
authors.initials: JK
authors.lastname: Gupta
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D000700:Analgesics / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D055356:Endometrial Ablation Techniques / Q000009:adverse effects / Q000379:methods*; D004717:Endometrium / Q000294:innervation / Q000601:surgery*; D004739:England; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects; D007902:Length of Stay; D008595:Menorrhagia / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local
keywords: Heavy menstrual bleeding; office endometrial ablation; pain control