title: The Effect of Intrauterine Lidocaine and Rectal Indomethacin on Pain during Office Vaginoscopic Hysteroscopy: Randomized Double-Blind Controlled Study.
abstract: OBJECTIVE
  The aim of this study was to investigate the effect of rectal and intrauterine anesthesia during vaginoscopic hysteroscopy.
  
  
  METHODS
  This was a randomized, double-blind, placebo-controlled study. Patients were randomized to rectal indomethacin, intrauterine lidocaine and placebo groups. Patients with conditions that could cause or contribute to pelvic pain were excluded. Pain was evaluated with Visual Analog Scale, when the cervical canal was passed, while within the cavity and at 10 min after procedure. The Analog Pain Scale scores of the 3 groups were compared with the Kruskal-Wallis 1-way analysis of variance test. A value of p < 0.05 was accepted as statistically significant.
  
  
  RESULTS
  The study included a total of 206 patients. No difference was seen between the groups in respect of indication, age, gravid and duration of procedure. While the anesthesia was determined as superior to the placebo in reducing pain at all 3 stages (p < 0.05), intrauterine lidocaine was determined to be more effective than rectal indomethacin in reducing pain within the cavity and 10 min after the procedure (p < 0.05).
  
  
  CONCLUSIONS
  Rectal or intrauterine anesthesia applied with the vaginoscopic technique is useful in hysteroscopy. However, intrauterine anesthesia is more effective in reducing pain.
authors.affiliation: Department of Obstetrics and Gynecology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet Baki
authors.initials: MB
authors.lastname: Senturk
authors.forename: Hakan
authors.initials: H
authors.lastname: Guraslan
authors.forename: Bülent
authors.initials: B
authors.lastname: Babaoğlu
authors.forename: Levent
authors.initials: L
authors.lastname: Yaşar
authors.forename: Mesut
authors.initials: M
authors.lastname: Polat
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects; D000779:Anesthetics, Local; D004311:Double-Blind Method; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D007213:Indomethacin / Q000008:administration & dosage*; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010919:Placebos; D011127:Polyps / Q000175:diagnosis; D012007:Rectum / Q000187:drug effects; D014599:Uterus / Q000187:drug effects
chemical_list: D000779:Anesthetics, Local; D010919:Placebos; D008012:Lidocaine; D007213:Indomethacin