Infertility, Female
Conditions
Keywords
intracervical anasthesia , outpatient hystroscopy ,
Brief summary
Single blind randomized controlled study in which 80 patients coming for hystroscopy due to multiple indication as infertility, AUB and missed IUD were assigned for our study. Both Sample size and randomization were done by a computer program. Patients were classified into 2 groups, group 1 study group was subjected to intracervical injection of 5 mi of mepivacaine hydrochloride at position 3 and 9 of the vaginal portion of the cervix, and at least 5 minutes post injection before procedure done. The control group received NSAI injection 15 minutes before procedure and 5 ml of saline was injected in each side of cervix at 3 9 positions. Hystroscopy was done if an abnormality is detected an intervention was done. A descriptive scale of pain was done into mild, moderate or severe (that lead to interruption of the procedures).
Detailed description
Procedures: All patients were subjected to: 1. History taking 2. Verbal consent to participate in our study 3. Patient put in lithotomy position 4. Casco speculum was applied exposing the cervix 5. Betadine sterilization of the cervix then properly washed with saline as heavy metals of disinfectant may cause irritation with injection 6. Multiple toothed volselum was used just to fix cervix 7. 3 cartridges of mepivacaine hydrochloride was filled in 10 mi syringe 8. Do aspiration to exclude and avoid intravascular injection then infilterate slowly intracervical at both 3 and 9 positions 9. Instruments are removed and at least 5 minutes later procedure started. 10. Hystroscopy (rigid , 2.9 mm sheath) was introduced gently throw vaginoscopy exploring vagina , cervix and uterine cavity 11. Patient was monitored for pain all through the procedure by descriptive scale, mild, moderate and severe. ( moderate who needed to take rest then continue , severe that necessitated interruption of the procedure 12. All patients were monitored for signs of vaso vagal attack as sings (low blood pressure and bradycardia) before and if needed during. Occurrence of symptoms as pallor , sweet and fainting 13. All patients were monitored post procedure for persistence of colicky pain
Interventions
PROCEDUREstudy group
local anesthesia by mepicaine hydrochloride by intracervical local injection using 10 mm syringe.
PROCEDUREcontrol group
each patient receives one tablet of NSAIDs (diclofenac sodium 50 mg) and 5ml of a placebo in form of normal saline are injected intracervical 5 minutes before the procedure using 10 mm syringe.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Subject)
Masking description
group 1 will be subjected to intracervical injection of mepicaine hydrochloride 3%iof a local anasthetic as Carbocaine3% and group 2 will be subjected to intracervical injection of 5 ml of normal saline
Intervention model description
two groups will be used , 1st study group using intracervical anasthesia of a local anasthetic as Carbocaine3%,and 2nd group using NSAIDs and intracervical injection of a placebo ( saline ).Ask the patient to tell about any sense of nausea or vomiting or drowsiness.
Eligibility
Sex/Gender
FEMALE
Age
No minimum to 40 Years
Healthy volunteers
Yes
Inclusion criteria
1. must be under 40 years 2. must be no history of renal or hepatic disease 3. must be no known hypersensitivity to local anaesthetic agents 4. must be no significant vaginal or cervical infection.
Exclusion criteria
* All patients with history of sever vasovagal attack during any gynecological procedures.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| tolerated hystroscopy | 30 minutes | complete hystroscopy procedure with tolerable degree of pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| occurrence of complication | 30 minutes | symptoms of vasovagal as vomiting , sweeting and bradycardia |
Countries
Egypt
Outcome results
None listed