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Paracervical Block

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181. Hysteroscopy (Diagnosis)

enough to require minimal cervical dilation. In addition, patients tolerate this instrument well with only paracervical block anesthesia. Rigid scopes larger than 5 mm in diameter (commonly 8-10 mm) require increased cervical dilation for insertion. Therefore, they are most frequently used in the operating room with intravenous (IV) sedation or . Large instruments include an outer sheath to introduce and remove media and to provide ports to accommodate large and varied surgical instruments. Flexible

2014 eMedicine.com

182. Manual versus electric vacuum aspiration for first-trimester abortion: a systematic review

perforation, blood loss or severe pain perception, were eligible. The secondary outcomes were operation time, cost and acceptability of the abortion method. The studies were conducted in the USA, China and Sweden. Where reported, women were given paracervical block for pain management. The mean age of the participants ranged from 23 to 29 years, and gestational age ranged from ≤42 to ≤77 days. The duration of follow-up ranged from 1 to 8 weeks, with four only following up until discharge from hospital

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2008 DARE.

183. Pain relief for women undergoing oocyte retrieval for assisted reproduction. (PubMed)

and acupuncture anaesthesia; 3) conscious sedation and analgesia plus paracervical block versus other active interventions such as general, spinal and acupuncture anaesthesia; 4) patient-controlled conscious sedation and analgesia versus physician-administered conscious sedation and analgesia; and 5) conscious sedation and analgesia with different agents or dosage. Evidence was generally of low quality, mainly due to poor reporting of methods, small sample sizes and inconsistency between (...) the trials.Conflicting results were shown for women's experience of pain. Compared to conscious sedation alone, more effective pain relief was reported when conscious sedation was combined with electro-acupuncture: intra-operative pain mean difference (MD) on 1 to 10 visual analogue scale (VAS) of 3.00 (95% CI 2.23 to 3.77); post-operative pain MD in VAS units of 2.10 (95% CI 1.40 to 2.80; N = 61, one trial, low quality evidence); or paracervical block (MD not calculable).The pooled data of four trials showed

2013 Cochrane database of systematic reviews (Online)

184. Use of an Algorithm to Determine IV Sedation Dosing During First-trimester Surgical Abortion

: Pain with suction curettage [ Time Frame: Measured on Day 1 (day of enrollment), immediately (within one minute) after completion of suction curettage and speculum removal ] Subjects' pain score with suction curettage on a 0-100 21-point scale Secondary Outcome Measures : Pain with paracervical block [ Time Frame: Measured on Day 1 (day of enrollment), immediately after paracervical block ] Pain with paracervical block will be measured (a) on a 21-point 0 to 100 scale (in increments of five (...) ), and (b) on a subjective scale of "no pain, mild pain, moderate pain or severe pain." Pain will be measured immediately after paracervical block. Pain with cervical dilation [ Time Frame: Measured on Day 1 (day of enrollment), immediately after cervical dilation ] Pain with cervical dilation will be measured (a) on a 21-point 0 to 100 scale (in increments of five), and (b) on a subjective scale of "no pain, mild pain, moderate pain or severe pain." Pain with cervical dilation will be measured

2013 Clinical Trials

185. Evaluation of Oral Midazolam in First-trimester Surgical Abortions

by (Responsible Party): Lisa Bayer, MD MPH, Oregon Health and Science University Study Details Study Description Go to Brief Summary: The purpose of this study is to determine the level of pain, anxiety and side effects that women experience with a surgical abortion and the effect that the anti-anxiety medication, midazolam, might have when used along with ibuprofen and a paracervical block (PCB) instead of the standard pain treatment of only ibuprofen and a PCB. Condition or disease Intervention/treatment

2013 Clinical Trials

186. Optimizing Patient Analgesic Experience During IVF

Patient Analgesic Experience During IVF Study Start Date : March 2013 Estimated Primary Completion Date : December 2014 Estimated Study Completion Date : December 2014 Resource links provided by the National Library of Medicine related topics: available for: Arms and Interventions Go to Arm Intervention/treatment Placebo Comparator: Normal Saline Conscious sedation and sterile normal saline (placebo) paracervical block Drug: Sterile Normal Saline% Sterile normal saline used as placebo for lidocaine (...) hydrochloride (HCl)1% solution Other Name: Sterile Normal Saline Active Comparator: Lidocaine Conscious sedation and Lidocaine hydrochloride 1% solution paracervical block Drug: Lidocaine hydrochloride (HCl) 1% solution Comparison of paracervical block using Lidocaine versus Normal Saline placebo in patients undergoing oocyte retrieval during IVF. Other Name: Xylocaine Outcome Measures Go to Primary Outcome Measures : Pain scores rated on SF-MPQ [ Time Frame: Data collection is scheduled to proceed until

2013 Clinical Trials

187. Pain and Suction Curettage

the analgesic efficacy of preoperative oral dexketoprofen trometamol, intravenous paracetamol, lidocaine spray and paracervical block with ultracaine on curettage procedure. Condition or disease Intervention/treatment Phase Curettage Analgesia Paracervical Block Paracetamol Drug: paracetamol Drug: dexketoprofen trometamol Drug: suction curettage Other: without drug Not Applicable Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 111 (...) Study group Drug: dexketoprofen trometamol Active Comparator: two puff xylocain administration on cervical surface Study group Drug: suction curettage Other Name: two puff xylocain administration Active Comparator: paracervical block with ultracaine study group Drug: suction curettage Other Name: paracervical block with ultracaine Outcome Measures Go to Primary Outcome Measures : pain reduction [ Time Frame: nine months ] Eligibility Criteria Go to Information from the National Library of Medicine

2013 Clinical Trials

188. Pain management for tubal sterilization by hysteroscopy. (PubMed)

was 167. Using a 10-cm VAS to measure pain, no significant difference emerged in overall pain for the entire procedure between women who received a paracervical block with lidocaine versus normal saline (mean difference -0.77; 95% CI -2.67 to 1.13). No significant difference in pain score was noted at the time of injection of study solution to the anterior lip of the cervix (mean difference -0.6; 95% CI -1.3 to 0.1), placement of the device in the tubal ostia (mean difference -0.60; 95% CI -1.8 to 0.7 (...) ), and postprocedure pain (mean difference 0.2; 95% CI -0.8 to 1.2). Procedure time (mean difference -0.2 minutes; 95% CI -2.2 to 1.8 minutes) and successful bilateral placement (OR 1.0; 95% CI 0.19 to 5.28) was not significantly different between groups. During certain portions of the procedure, such as placement of the tenaculum (mean difference -2.03; 95% CI -2.88 to -1.18), administration of the paracervical block (mean difference -1.92; 95% CI -2.84 to -1.00), and passage of the hysteroscope through

2012 Cochrane database of systematic reviews (Online)

189. Cervical Ripening Before Endometrial Biopsy in Abnormal Uterine Bleeding Using Sublingual Misoprostol

was: Recruiting First Posted : January 7, 2013 Last Update Posted : January 7, 2013 Sponsor: Mahidol University Information provided by (Responsible Party): Mahidol University Study Details Study Description Go to Brief Summary: Abnormal uterine bleeding is common in Thai women. Fractional curettage is an diagnostic procedure of this condition. Traditionally, fractional curettage is performed under local anesthesia such as paracervical nerve block or intravenous meperidine. Cervical dilatation using "metal

2012 Clinical Trials

190. Efficacy of Diclofenac on Pain During Endometrial Sampling

by (Responsible Party): Mahidol University Study Details Study Description Go to Brief Summary: Abnormal uterine bleeding is common in Thai women. Traditionally, because of a larger number of patients, the diagnosis of its cause is performed via fractional curettage under local anesthesia such as paracervical nerve block or intravenous meperidine. Pain is one of a common adverse effect of this procedure and this topic should be concerned by a responsible doctor. NSAIDs, Diclofenac Potassium in this study (...) paracervical nerve block due to abnormal uterine bleeding" Double blind randomised controlled trial was performed in this study with 45 patients included in each group. Condition or disease Intervention/treatment Phase Abnormal Uterine Bleeding Unrelated to Menstrual Cycle Drug: Diclofenac Potassium Drug: Folic Acid Not Applicable Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 90 participants Allocation: Randomized Intervention

2012 Clinical Trials

191. Intrauterine Lidocaine for Laminaria

: This is a study to investigate whether instilling a small amount of liquid lidocaine into the uterus will decrease pain felt by women during laminaria insertions done for cervical dilation prior to second trimester abortion. The investigators hypothesize that women who receive intrauterine lidocaine in addition to a paracervical block will experience less pain than women who receive only a paracervical block. Condition or disease Intervention/treatment Phase Abortion, Induced Pain Management Drug: Lidocaine

2012 Clinical Trials

192. Lidocaine Spray Compared With Submucosal Injection During LEEP: a Randomized Controlled Trial

Mai University Information provided by (Responsible Party): Kittipat Charoenkwan, M.D., Chiang Mai University Study Details Study Description Go to Brief Summary: Loop Electrosurgical Excision Procedure (LEEP) is a widely used minor surgical procedure for diagnosis and treatment of cervical intraepithelial neoplasia. During the procedure, several methods have been proposed to reducing pain including submucosal block, paracervical block, and oral analgesics. Submucosal (underneath the lining

2012 Clinical Trials

193. Pain Control for Intrauterine Device Placement: A Trial of Ketorolac Prior to Intrauterine Device Placement

effective form of birth control. The current standard of care for pain management during and after IUD placement is no medication, as randomized control trials published to date have limited data regarding use of medications to decrease pain. There has been one trial to suggest that the use of naproxen with 1% lidocaine paracervical block compared to paracervical block alone may decrease pain after IUD placement in primarily nulliparous patients. However, this study was with the much wider and no longer

2012 Clinical Trials

194. Study of Local Anesthesia as a Method to Decrease IUD Insertion Related Pain

a vaginal delivery before. The investigators anticipate that among women who have not had a previous vaginal delivery, the pain associated with IUD insertion will be significantly decreased after administration of local anesthesia. Condition or disease Intervention/treatment Phase IUD Insertion Complication Pain Control Drug: Lidocaine Drug: Placebo Phase 4 Detailed Description: The study will investigate the difference in perceived pain from IUD insertion, comparing paracervical block with lidocaine (...) to a placebo (bacteriostatic saline) block, among nulliparous and "functionally nulliparous" women. The investigators plan a double-masked, placebo controlled, randomized clinical trial. The investigators anticipate that among patients who have not had a previous vaginal delivery, the pain associated with IUD insertion will be significantly decreased after administration of a 15 mL 1% lidocaine paracervical block compared to patients who receive 15 mL of bacteriostatic saline (placebo). Study Design Go

2012 Clinical Trials

195. Music as an auxiliary analgesic during first trimester surgical abortion: a randomized controlled trial. (PubMed)

Music as an auxiliary analgesic during first trimester surgical abortion: a randomized controlled trial. Music has served as an auxiliary analgesic in perioperative settings. This study evaluates the impact of intraoperative music added to routine pain control measures during first trimester surgical abortion.We analyzed data from 101 women randomized to undergo abortion with routine pain control measures only (ibuprofen and paracervical block) or with the addition of intraoperative music via

2012 Contraception Controlled trial quality: predicted high

196. A double-blind, randomized controlled trial of the use of a 50:50 mixture of nitrous oxide/oxygen in legal abortions. (PubMed)

A double-blind, randomized controlled trial of the use of a 50:50 mixture of nitrous oxide/oxygen in legal abortions. The study was conducted to evaluate the effectiveness of oxygen/nitrous oxide (O(2)/N(2)O) in elective abortions by vacuum aspiration with paracervical block and intravenous paracetamol.This single-center double-blinded randomized study tested O(2)/N(2)O (n=36) and placebo (air, n=36) for additional analgesia in elective abortions with paracervical block and intravenous (...) postoperative and late postoperative pain did not differ significantly between the groups. Total adverse effects were significantly higher in the O(2)/N(2)O group [35/180 (19.4%) vs. 18/180 (10%), p=.01].O(2)/N(2)O did not reduce intraoperative or postoperative pain in elective abortions by vacuum aspiration with paracervical analgesia and intravenous paracetamol, and its adverse effect rate was substantial.Copyright © 2012 Elsevier Inc. All rights reserved.

2012 Contraception Controlled trial quality: predicted high

197. Intrauterine lidocaine infusion for pain management during outpatient transcervical tubal sterilization: a randomized controlled trial. (PubMed)

Intrauterine lidocaine infusion for pain management during outpatient transcervical tubal sterilization: a randomized controlled trial. The study was conducted to examine the effects of a 4% intrauterine lidocaine infusion on patient-perceived pain during transcervical sterilization.This was a randomized, double-blind, placebo-controlled trial. Subjects received standard premedication with 800 mg ibuprofen, 2 mg lorazepam, a 10-mL 1% lidocaine paracervical block and transcervical instillation

2012 Contraception Controlled trial quality: predicted high

198. Comparison of efficacy of modified electric vacuum aspiration with sharp curettage for the treatment of incomplete abortion: randomized controlled trial. (PubMed)

) underwent mEVA and group B (n=47) underwent SC. The procedures were performed using the paracervical block with 20 mL of lidocaine. Successful management and complication were assessed. Successful management was defined as complete uterine evacuation with no need for the second surgical procedure.There were differences in women characteristics between groups. The successful rate of management was 100% for both groups. However, the operative time and estimated blood loss were less in the mEVA group than

2012 The journal of obstetrics and gynaecology research Controlled trial quality: uncertain

199. Pain control in first-trimester and second-trimester medical termination of pregnancy: a systematic review. (PubMed)

or paracervical block on pain; one study found that women at >15 weeks' gestation who received diclofenac with the first misoprostol dose required less opioid analgesia than women who received acetaminophen+codeine.Few studies examine pain management during medical abortion, and heterogeneity of existing data limits comparison. Further research is needed to determine the optimal analgesia regimens for first-trimester and second-trimester medical termination of pregnancy. To facilitate comparability of data

2011 Contraception

200. Sacro-lumbar intersegmental spinal reflex in autonomic pathways mediating female sexual function. (PubMed)

intersegmental spinal circuit to midlumbar levels in addition to the sacral spinal circuit. These CAPs in hypogastric nerves were enhanced by bicuculline (10 µM), blocked by tetrodotoxin (1 µM) but were not affected by hexamethonium (200 µM). Retrograde axonal tracing revealed four groups of sensory neurons in S3 dorsal root ganglia that were distinguished immunohistochemically. Midlumbar preganglionic neurons projecting to paracervical ganglia regulating blood flow and motility in the female reproductive (...) Sacro-lumbar intersegmental spinal reflex in autonomic pathways mediating female sexual function. Autonomic neurons in paracervical ganglia mediating vasodilation in the female reproductive tract receive inputs from both midlumbar and sacral spinal levels. However, it is not known how the lumbar pathways are activated.This study tested whether stimulation of pudendal sensory nerve could activate lumbar spinal outflows to paracervical ganglia via a spinal reflex pathway.Isolated spinal cords

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2011 Journal Of Sexual Medicine

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