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Hum. Reprod. Advance Access published online on February 14, 2006
Human Reproduction, doi:10.1093/humrep/del023
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received October 10, 2005
Revised December 3, 2005
Accepted January 13, 2006

Article

Effect of local lignocaine gel application for pain relief during suction termination of first-trimester pregnancy: a randomized controlled trial

H.W.R. Li 1 *, C.Y.G. Wong 1, S.S.T. Lo 1, and S.Y.S. Fan 1

1 The Family Planning Association of Hong Kong, Wanchai, Hong Kong SAR, China

* To whom correspondence should be addressed.
H.W.R. Li, E-mail: hwli{at}famplan.org.hk and raymondli@hkam.org.hk


  Abstract

BACKGROUND: This study evaluated the effectiveness of local lignocaine gel application in pain control during first-trimester suction termination of pregnancy (STOP). METHODS: In this prospective randomized placebo-controlled double-blind trial, 131 women undergoing STOP between 7 and 10 weeks of gestation were studied. They were computer-randomized to receive 2% lignocaine gel or placebo (KY Jelly) locally applied to the cervix 1 min before cervical manipulation/dilatation. They all had cervical priming with misoprostol and premedication with diazepam and pethidine. Pain scores on a verbal analogue scale preoperative, at cervical manipulation/dilatation, intraoperative and 1 h post-operative, as well as the patients’ satisfaction level towards pain control, were compared. RESULTS: The lignocaine gel group had significantly reduced overall intraoperative pain score compared with placebo group (P = 0.021). No significant difference in pain score between the two groups was demonstrated at other time points. Subgroup analysis revealed that the difference in overall intraoperative pain scores between the two groups was evident in the multiparous (P = 0.015) but not the nulliparous subjects. CONCLUSION: The use of local lignocaine gel application reduces overall intraoperative pain in multiparous women undergoing first-trimester STOP preceded by misoprostol cervical priming and premedication for conscious sedation.

Keywords: lignocaine gel/pain relief/randomized controlled trial/suction evacuation/termination of pregnancy.
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