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Hum. Reprod. Advance Access originally published online on April 7, 2004
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Human Reproduction, Vol. 19, No. 5, 1116-1120, May 2004
© 2004 European Society of Human Reproduction and Embryology

Lidocaine vaginal gel versus lidocaine paracervical block for analgesia during oocyte retrieval

Ian Tummon1,2,6, Christopher Newton1,3, Clive Lee1,4 and James Martin1,5

1 Department of Obstetrics and Gynaecology, The University of Western Ontario, London, Ontario, Canada 3 Department of Obstetrics and Gynaecology, Department of Psychology, The University of Western Ontario, London, Ontario, Canada

2 Present address, Mayo Clinic, 200 First Street SW, Rochester MN 55905, USA

4 Present address, Humber River Regional Hospital, Toronto, Ontario, Canada

5 Present address, Southern Ontario Fertility Technologies, London, Ontario, Canada

6 To whom correspondence should be addressed. e-mail: tummon.ian{at}mayo.edu.

BACKGROUND: Evidence from randomized trials suggests that pain relief during oocyte retrieval is superior when adjunctive paracervical block is used in addition to sedation alone. Vaginal application of lidocaine gel is a non-invasive alternative to lidocaine paracervical block. The goal of the present trial was to compare analgesia with lidocaine vaginal gel versus lidocaine paracervical block. METHODS: A parallel-group randomized trial of adjunctive lidocaine vaginal gel versus adjunctive lidocaine paracervical block (with sedation for both groups) was performed in participants undergoing oocyte retrieval. Measured outcomes were subjective pain experiences. Subjects provided self-reported ratings of pain and anxiety. Visual analogue scales were used to measure pain during different procedural stages. The McGill Pain Questionnaire was used to measure pain character and the total pain experience. RESULTS: During application of lidocaine, pain ratings were less for vaginal gel than paracervical block. In contrast, during insertion of the aspiration needle and aspiration of follicles, pain ratings were greater for lidocaine vaginal gel. Total pain experience was greater with lidocaine vaginal gel. CONCLUSIONS: Subjective measures of pain intensity and the total pain experience were greater with lidocaine vaginal gel compared with lidocaine paracervical block.

Key words: analgesia/lidocaine/oocyte retrieval/pain/sedation


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