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Research paper
Published online: 2021-04-14
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Does intravenous lidocaine added to nonsteroidal anti-inflammatory drugs reduce pain during colposcopy? A prospective randomized double-blind study

Yunus Emre Topdaği1, Emsal Pinar Topdagi Yilmaz2, Muhammed Enes Aydin3, Irem Ates3, Elif Oral Ahiskalioglu3
DOI: 10.5603/GP.a2021.0058
·
Pubmed: 33914314
Affiliations
  1. Department of Gynecology and Obstetrics, Marmara University School of Medicine, Turkey
  2. Department of Obstetrics and Gynecology, Ataturk University, Erzurum, Turkey
  3. Department of Anesthesiology and Reanimation, Ataturk University, Medical Faculty, Erzurum, Turkey

open access

Ahead of Print
ORIGINAL PAPERS Gynecology
Published online: 2021-04-14

Abstract

Objectives: In recent years, lidocaine infusion for pain management during long operations is becoming more widespread in anesthesiology practice. However, only a limited number of studies have reported the intravenous use of lidocaine for short-term interventions. The aim of this study was to investigate the effectiveness of intravenous lidocaine use in pain management during colposcopic cervical biopsy and endocervical curettage (ECC).

Material and methods: Patients between the ages of 18 and 65 years with abnormal cytological findings or who were determined to be human papillomavirus (HPV)-positive were included in this randomized double-blind study. The lidocaine group (Group L, n = 30) was intravenously administered 50 mg dexketoprofen + 1.5 mg/kg lidocaine in 10 mL saline for 3 min 30 min before the procedure. The control group (Group C, n = 30) was intravenously administered 50 mg dexketoprofen in 10 mL saline for 3 min, 30 min before the procedure. During the procedure, pain scores were assessed using the visual analogue scale (VAS). In addition, patients, operator satisfaction and duration of procedure were assessed

Results: There were no differences in the demographic data of the groups. Pain scores during biopsy and ECC were significantly lower in Group L than in Group C (p < 0.001). The duration of the procedure was significantly shorter in Group L than in Group C (5.00 ± 0.78 vs 6.12 ± 1.16, respectively; p < 0.001). Patient and operator satisfaction were significantly higher in Group L than in Group C (p < 0.001).

Conclusions: Intravenous lidocaine administration can be used as an alternative approach to reduce pain and increase operator and patient satisfaction during colposcopy-directed biopsy and ECC procedures in office settings.

Abstract

Objectives: In recent years, lidocaine infusion for pain management during long operations is becoming more widespread in anesthesiology practice. However, only a limited number of studies have reported the intravenous use of lidocaine for short-term interventions. The aim of this study was to investigate the effectiveness of intravenous lidocaine use in pain management during colposcopic cervical biopsy and endocervical curettage (ECC).

Material and methods: Patients between the ages of 18 and 65 years with abnormal cytological findings or who were determined to be human papillomavirus (HPV)-positive were included in this randomized double-blind study. The lidocaine group (Group L, n = 30) was intravenously administered 50 mg dexketoprofen + 1.5 mg/kg lidocaine in 10 mL saline for 3 min 30 min before the procedure. The control group (Group C, n = 30) was intravenously administered 50 mg dexketoprofen in 10 mL saline for 3 min, 30 min before the procedure. During the procedure, pain scores were assessed using the visual analogue scale (VAS). In addition, patients, operator satisfaction and duration of procedure were assessed

Results: There were no differences in the demographic data of the groups. Pain scores during biopsy and ECC were significantly lower in Group L than in Group C (p < 0.001). The duration of the procedure was significantly shorter in Group L than in Group C (5.00 ± 0.78 vs 6.12 ± 1.16, respectively; p < 0.001). Patient and operator satisfaction were significantly higher in Group L than in Group C (p < 0.001).

Conclusions: Intravenous lidocaine administration can be used as an alternative approach to reduce pain and increase operator and patient satisfaction during colposcopy-directed biopsy and ECC procedures in office settings.

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Keywords

pain; colposcopy; lidocaine

About this article
Title

Does intravenous lidocaine added to nonsteroidal anti-inflammatory drugs reduce pain during colposcopy? A prospective randomized double-blind study

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-04-14

DOI

10.5603/GP.a2021.0058

Pubmed

33914314

Keywords

pain
colposcopy
lidocaine

Authors

Yunus Emre Topdaği
Emsal Pinar Topdagi Yilmaz
Muhammed Enes Aydin
Irem Ates
Elif Oral Ahiskalioglu

References (29)
  1. Denny L. Cervical cancer: prevention and treatment. Discovery medicine. 2012; 14(75): 125–31.
  2. Musa J, Achenbach CJ, O'Dwyer LC, et al. PLOS ONE Staff. Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis. PLoS One. 2017; 12(9): e0183924.
  3. Papanicolaou GN, Traut HF. The diagnostic value of vaginal smears in carcinoma of the uterus. 1941. Arch Pathol Lab Med. 1997; 121(3): 211–224.
  4. Benedet JL, Bertrand MA, Matisic JM, et al. Costs of colposcopy services and their impact on the incidence and mortality rate of cervical cancer in Canada. J Low Genit Tract Dis. 2005; 9(3): 160–166.
  5. Benedet JL, Matisic JP, Bertrand MA. An analysis of 84244 patients from the British Columbia cytology-colposcopy program. Gynecol Oncol. 2004; 92(1): 127–134.
  6. Wongluecha T, Tantipalakorn C, Charoenkwan K, et al. Effect of lidocaine spray during colposcopy-directed cervical biopsy: A randomized controlled trial. J Obstet Gynaecol Res. 2017; 43(9): 1460–1464.
  7. Clifton PA, Shaughnessy AF, Andrews S. Ineffectiveness of topical benzocaine spray during colposcopy. J Fam Pract. 1998; 46(3): 242–246.
  8. Prefontaine M, Fung-Kee-Fung M, Moher D. Comparison of topical Xylocaine with placebo as a local anesthetic in colposcopic biopsies. Can J Surg. 1991; 34(2): 163–165.
  9. Rabin JM, Spitzer M, Dwyer AT, et al. Topical anesthesia for gynecologic procedures. Obstet Gynecol. 1989; 73(6): 1040–1044.
  10. Rodney WM, Huff M, Euans D, et al. 3rd. Colposcopy in family practice: pilot studies of pain prophylaxis and patient volume. Family practice research journal. 1992; 12(1): 91–98.
  11. Öz M, Korkmaz E, Cetinkaya N, et al. Comparison of Topical Lidocaine Spray With Placebo for Pain Relief in Colposcopic Procedures: A Randomized, Placebo-Controlled, Double-Blind Study. J Low Genit Tract Dis. 2015; 19(3): 212–214.
  12. E Silva LO, Scherber K, Cabrera D, et al. Safety and Efficacy of Intravenous Lidocaine for Pain Management in the Emergency Department: A Systematic Review. Ann Emerg Med. 2018; 72(2): 135–144.e3.
  13. Allen RH, Micks E, Edelman A. Pain relief for obstetric and gynecologic ambulatory procedures. Obstet Gynecol Clin North Am. 2013; 40(4): 625–645.
  14. Karaman E, Kolusarı A, Alkış İ, et al. Comparison of topical lidocaine spray with forced coughing in pain relief during colposcopic biopsy procedure: a randomised trial. J Obstet Gynaecol. 2019; 39(4): 534–538.
  15. Schmid BC, Pils S, Heinze G, et al. Forced coughing versus local anesthesia and pain associated with cervical biopsy: a randomized trial. Am J Obstet Gynecol. 2008; 199(6): 641.e1–641.e3.
  16. Naki MM, Api O, Acioglu HC, et al. Analgesic efficacy of forced coughing versus local anesthesia during cervical punch biopsy. Gynecol Obstet Invest. 2011; 72(1): 5–9.
  17. Wong GCY, Li RHW, Wong TS, et al. The effect of topical lignocaine gel in pain relief for colposcopic assessment and biopsy: is it useful? BJOG. 2008; 115(8): 1057–1060.
  18. Moeen SM, Moeen AM. Usage of Intravenous Lidocaine Infusion with Enhanced Recovery Pathway in Patients Scheduled for Open Radical Cystectomy: A Randomized Trial. Pain Physician. 2019; 22(2): E71–E80.
  19. Weibel S, Jelting Y, Pace NL, et al. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery in adults. Cochrane Database Syst Rev. 2018; 6: CD009642.
  20. Forster C, Vanhaudenhuyse A, Gast P, et al. Intravenous infusion of lidocaine significantly reduces propofol dose for colonoscopy: a randomised placebo-controlled study. Br J Anaesth. 2018; 121(5): 1059–1064.
  21. van de, van de, Radema SA, et al. The in vitro mechanisms and in vivo efficacy of intravenous lidocaine on the neuroinflammatory response in acute and chronic pain. European journal of pain. 2016; 20(5): 655–74.
  22. Dunn LK, Durieux ME. Perioperative Use of Intravenous Lidocaine. Anesthesiology. 2017; 126(4): 729–737.
  23. McCleane G. Intravenous lidocaine: an outdated or underutilized treatment for pain? J Palliat Med. 2007; 10(3): 798–805.
  24. Kranke P, Jokinen J, Pace NL, et al. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery. Cochrane Database Syst Rev. 2015(7): CD009642.
  25. Challapalli V, Tremont-Lukats IW, McNicol ED, et al. Systemic administration of local anesthetic agents to relieve neuropathic pain. Cochrane Database Syst Rev. 2005; 2019(4): CD003345.
  26. Tremont-Lukats IW, Challapalli V, McNicol ED, et al. Systemic administration of local anesthetics to relieve neuropathic pain: a systematic review and meta-analysis. Anesth Analg. 2005; 101(6): 1738–1749.
  27. Church L, Oliver L, Dobie S, et al. Analgesia for colposcopy: double-masked, randomized comparison of ibuprofen and benzocaine gel. Obstet Gynecol. 2001; 97(1): 5–10.
  28. Oyama IA, Wakabayashi MT, Frattarelli LC, et al. Local anesthetic reduces the pain of colposcopic biopsies: a randomized trial. Am J Obstet Gynecol. 2003; 188(5): 1164–1165.
  29. Limwatanapan N, Chalapati W, Songthamwat S, et al. Lidocaine Spray Versus Paracervical Block During Loop Electrosurgical Excision Procedure: A Randomized Trial. J Low Genit Tract Dis. 2018; 22(1): 38–41.

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