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Paracervical Block

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141. Evaluation of a Novel Technique for Intrauterine Contraceptive Devices Insertion

insertion starting by simple methods such as pre-insertion ibuprofen use, intracervical or intrauterine lidocaine and misoprostol up to paracervical blocks. Previous studies, in literature, have found that the most painful steps during intrauterine devices insertion were uterine sounding then intrauterine device insertion itself, followed by tenaculum placement. One recent study addressed pain effect using an atraumatic vulsellum and a single-tooth tenaculum on pain perception during intrauterine

2016 Clinical Trials

142. Self-administered Lidocaine Gel for Pain-control During Cervical Preparation for Dilation and Evacuation

: April 17, 2018 Last Update Posted : April 17, 2018 Sponsor: Stanford University Information provided by (Responsible Party): Stanford University Study Details Study Description Go to Brief Summary: This study seeks to compare self-administered lidocaine gel for pain control during cervical preparation for dilation and evacuation (D&E) to paracervical block. Condition or disease Intervention/treatment Phase Pain Management, Cervical Preparation Drug: Lidocaine Gel (2%) Drug: Lidocaine Paracervical (...) Actual Study Completion Date : April 2017 Resource links provided by the National Library of Medicine related topics: available for: Arms and Interventions Go to Arm Intervention/treatment Experimental: Self-administered Gel Patient-administered, vaginal lidocaine gel (2%)--inserted 15 minutes prior to cervical preparation procedure Drug: Lidocaine Gel (2%) Active Comparator: Paracervical Block Provider-administered lidocaine (1%) paracervical injection--administered immediately prior to tenaculum

2016 Clinical Trials

143. Nitrous Oxide Versus Intravenous Sedation for Anesthesia

for: Arms and Interventions Go to Arm Intervention/treatment Experimental: Nitrous oxide and IV saline Participants in the nitrous oxide group will receive a scented face mask through which nitrous oxide will be administered. The nitrous content of the gas will be titrated up by 20% every 5 breaths with a goal of 70% N2O/ 30% O2 as tolerated by the participant. This group will also receive saline through an IV. All participants will receive local anesthesia in the form of a paracervical block (...) and ibuprofen pre-operatively. Drug: Nitrous Oxide Participants in the nitrous oxide group will receive a scented face mask through which nitrous oxide will be administered. The nitrous content of the gas will be titrated up by 20% every 5 breaths with a goal of 70% N2O/ 30% O2 as tolerated by the participant. This group will also receive saline through an IV. All participants will receive local anesthesia in the form of a paracervical block and ibuprofen pre-operatively. Drug: IV Saline No Intervention

2016 Clinical Trials

144. A new minimally invasive treatment for cesarean scar pregnancy and cervical pregnancy. (PubMed)

prevent bleeding by compressing the blood supply of the gestational sac.Patients with diagnosed, live cervical pregnancy and cesarean scar pregnancy between 6 and 8 weeks' gestation were considered for the office-based treatment. Paracervical block with 1% lidocaine was administered in 3 patients for pain control. Insertion of the catheter and inflation of the upper balloon were done under transabdominal ultrasound guidance. The lower (pressure) balloon was inflated opposite the gestational sac under

2016 American Journal of Obstetrics and Gynecology

145. The optimal analgesic method in saline infusion sonogram: A comparison of two effective techniques with placebo (PubMed)

saline (controls, group 1), paracervical block (group 2), or paracervical block + intrauterine lidocaine (group 3). In all groups, a visual analogue scale score was performed during the tenaculum placement, while saline was administered, and 30 minutes after the procedure.When all the patients were evaluated, the difference in the visual analogue scale scores in premenopausal patients during tenaculum placement, during the saline infusion into the cavity, and 30 minutes following the saline infusion (...) sonography were statistically different between the saline and paracervical block groups, and between the saline and paracervical block + intrauterine lidocaine group. However, there was no statistically significant difference between paracervical block and paracervical block + intrauterine lidocaine groups.As a result of our study, paracervical block is a safe method to use in premenopausal patients to prevent pain during saline infusion sonography. The addition of intrauterine lidocaine

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2016 Turkish Journal of Obstetrics and Gynecology Controlled trial quality: uncertain

146. Self-Administered Lidocaine Gel for Pain Control With First-Trimester Surgical Abortion: A Randomized Controlled Trial. (PubMed)

as measured on a 100-mm visual analog scale. A sample size of 142 participants was planned to detect a 15-mm or greater difference on the 100-mm visual analog scale with 90% power and a significance level of .025, adding 10% for participant dropout and protocol violations. Participants received either 12 mL of a 1% lidocaine paracervical block or 20 mL of a self-administered, 2% lidocaine gel 20-30 minutes before procedure initiation. Secondary outcomes included anticipated pain, baseline pain, pain (...) with speculum and tenaculum placement, pain after suction aspiration, and pain 30-45 minutes postoperatively.From April to October 2015, a total of 142 women were enrolled (68 in the paracervical block group, 69 in the gel group, and five not analyzed as a result of participant withdrawal). Sociodemographic characteristics were similar between groups. The mean pain score with cervical dilation was 60 mm (95% confidence interval [CI] 54-66) in the paracervical block group and 64 mm (95% CI 59-69) in the gel

2016 Obstetrics and Gynecology Controlled trial quality: predicted high

147. Nitrous Oxide for Pain Management during in-office Hysteroscopic Sterilization: A Randomized Controlled Trial. (PubMed)

paracervical block. The intervention group also received N2O/O2 via a nasal mask titrated to a maximum 70%:30% mixture by a nurse during the procedure and placebo pills pre-procedure and the active control group received inhaled O2 during the procedure and 5/325 mg hydrocodone/acetaminophen and 1 mg lorazepam pre-procedure. The primary outcome was maximum procedure pain on a 100 mm Visual Analog Scale (VAS with anchors at 0=no pain and 100=worst imaginable pain) assessed 3-5 min post procedure. Thirty

2016 Contraception Controlled trial quality: predicted high

148. Intrapartum fetal surveillance

–A) less than 0.4 MoM) associated with an increased risk of poor perinatal outcomes (e.g. stillbirth, infant death, FGR, preterm birth and preeclampsia in a chromosomally normal fetus 15 ) · Vasa praevia Intrapartum 2 · Induction of labour with Prostaglandin · Abnormal auscultation or CTG · Oxytocin induction/augmentation · Regional analgesia (epidural or spinal) and paracervical block · Abnormal vaginal bleeding in labour · Maternal pyrexia (greater than or equal to 38 o C) · Meconium or blood stained (...) or more of the following antenatal or intrapartum indications are present in labour, CEFM is recommended 2 because of the synergistic effect on the woman: · 41 to 41 + 6 weeks gestation · Gestational hypertension · Gestational Diabetes Mellitus (GDM) without complicating factors · Obesity (BMI 30–40 kg/m 2 ) · Maternal age greater than or equal to 40 and less than 42 years · Maternal pyrexia (temperature 37.8 o C or 37.9 o C) · Prior to epidural block to establish baseline features 2 3 Fetal heart

2010 Clinical Practice Guidelines Portal

149. Applied Topical Heat as an Adjunct for Pain Control in First-Trimester Surgical Abortionl

Parenthood of New York City, Inc. Collaborator: Icahn School of Medicine at Mount Sinai Information provided by (Responsible Party): Planned Parenthood of New York City, Inc. Study Details Study Description Go to Brief Summary: Paracervical blocks are routinely used in first trimester surgical abortions and are a proven method for decreasing procedural pain. Even when paracervical anesthesia is used, an overwhelming majority of women still report at least moderate pain during a first trimester abortion (...) investigating the utility of topical heat application as an adjunct to paracervical block in first trimester surgical abortions up to 12 6/7wks. The primary outcome is pain score, measured using VAS, at time of uterine aspiration. As secondary outcomes, the investigators will look at the effect of heat application on pain at time of speculum placement, paracervical block, tenaculum placement, cervical dilation and overall pain. Patient satisfaction will also be assessed. If found to reduce pain during

2015 Clinical Trials

150. Fast-release Orodispersible Tramadol as Analgesia in Termination of Pregnancy by Vacuum Aspiration.

status was: Not yet recruiting First Posted : April 14, 2015 Last Update Posted : April 14, 2015 Sponsor: Universitair Ziekenhuis Brussel Information provided by (Responsible Party): Universitair Ziekenhuis Brussel Study Details Study Description Go to Brief Summary: If a termination of pregnancy procedure is performed by vacuum aspiration our patients receive a paracervical block. Nevertheless these patients are not free of pain. We randomised our patients: one group will receive additional (...) , then cervix and vagina were washed with an antiseptic solution. The cervix was grasped with a tenaculum and straigthened. A paracervical block was achieved using a 27-gauge spinal needle. Lidocaine was injected and distributed equally around the cervicovaginal junction at 1, 5, 7 and 11 o'clock. The suction curettage was accomplished through the following steps: the cervix was dilated, in function of the gestation, to Hagar number 5 to 11 (Aesculap, Ag and Co. KG, Tuttlingen, Germany); The uterine depth

2015 Clinical Trials

151. A Non-inferiority Trial on Pain Relief During Oocyte Retrieval

but are still painful without anaesthesia or analgesia. Intravenous sedation with or without local anaesthesia is the most widely used method. Conscious sedation is a safe and cost-effective method of providing analgesia and anesthesia for TUGOR. [2] It is easy to administer in cooperative and motivated patients. It has a relatively low risk for adverse effects on oocyte and embryo quality and pregnancy rates. [3] Paracervical block (PCB) in conjunction with conscious sedation during TUGOR was shown (...) to significantly reduce the pain during TUGOR when compared to PCB alone [4]. A Cochrane review on various methods of sedation and analgesia for pain relief during TUGOR has shown no single method or delivery system appeared superior for pregnancy rates and pain relief. [5] Most of the methods seemed to work well and the effect was usually enhanced by addition of another method such as pain relief with paracervical block. [6] The investigators' reproductive centre has recently aligned with the Assisted

2015 Clinical Trials

152. Study of Pain Control With Hormonal IUS Insertion

): Children's Hospital of Philadelphia Study Details Study Description Go to Brief Summary: This study aims to compare pain during insertion of the Skyla® IUS using a 100mm visual analog scale (VAS) among 92 young women aged 14 to 22 years randomized to receive a paracervical (n=46) block versus a sham paracervical block (n=46). Condition or disease Intervention/treatment Phase Pain Drug: Paracervical Nerve Block Drug: Sham Paracervical Block Phase 4 Detailed Description: Intrauterine systems (IUS (...) of this study. In addition to the size of an IUS, theoretical and empirical data suggest that paracervical blocks have the greatest promise for pain control during IUS insertion compared to other pain control options. Paracervical infiltration of a local anesthetic into the cervix interrupts the visceral sensory fibers of the lower uterus, cervix, and upper vagina. Data from several clinical trials indicate that paracervical blocks provide clinically significant control of pain during multiple types

2015 Clinical Trials

153. Insertion Characteristics of Intrauterine Devices in Adolescents and Young Women: Success, Ancillary Measures, and Complications. (PubMed)

identified and 24 patients (3.0%) expelled the IUD. Insertion failures and IUD expulsions were not related to IUD type, age, or parity.Intrauterine devices can be inserted in nulliparous adolescents of any age with similar success to parous adolescents, by both physicians and advanced practice clinicians. Inability to provide ancillary measures such as paracervical block or cervical dilation should not limit access to this first-line contraceptive method.Copyright © 2015 Elsevier Inc. All rights reserved.

2015 American Journal of Obstetrics and Gynecology

154. Guidelines on Diagnosis and Management of Syncope

? . . . . . . . . . . . . . . . . . 2650 2.2.4 Electrophysiological study . . . . . . . . . . . . . . . . . 2651 2.2.4.1 Suspected intermittent bradycardia . . . . . . . . . 2651 2.2.4.2 Syncope in patients with bundle branch block (impending high degree atrioventricular block) . 2652 2.2.4.3 Suspected tachycardia . . . . . . . . . . . . . . . . . 2652 2.2.5 Adenosine triphosphate test . . . . . . . . . . . . . . . 2652 2.2.6 Echocardiography and other imaging techniques . . 2653 2.2.7 Exercise stress testing (...) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2665 5.3.2 Proposed model . . . . . . . . . . . . . . . . . . . . . . . 2665 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2666 Abbreviations and acronyms ANF autonomic failure ANS autonomic nervous system ARVC arrhythmogenic right ventricular cardiomyopathy ATP adenosine triphosphate AV atrioventricular AVID Antiarrhythmics vs. Implantable De?brillators BBB bundle branch block BP blood pressure b.p.m. beats per minute CAD coronary artery disease CO cardiac output

2009 European Society of Cardiology

155. An Evaluation of Oral Midazolam for Anxiety and Pain in First-Trimester Surgical Abortion: A Randomized Controlled Trial. (PubMed)

ibuprofen and a paracervical block. We powered the study (power=80%; significance level=.025) to detect a 15-mm difference in our two a priori primary outcomes of pain and anxiety with uterine aspiration on a 100-mm visual analog scale. Secondary outcomes were pain and anxiety at additional time points, memory, satisfaction, side effects, and adverse events.Demographics were similar between groups (placebo=62, midazolam=62). Compared with those randomized to placebo, patients who received midazolam had

2015 Obstetrics and Gynecology Controlled trial quality: predicted high

156. Comparison of four different pain relief methods during hysterosalpingography: A randomized controlled study. (PubMed)

with HSG.In the present prospective study, 75 patients undergoing HSG for evaluation of infertility were randomly assigned to four groups: 550 mg of a nonsteroidal anti-inflammatory drug (NSAID) (group 1); 550 mg NSAID + paracervical block (group 2); 550 mg NSAID + paracervical analgesic cream (group 3); or 550 mg NSAID + intrauterine analgesic instillation (group 4). A visual analogue scale was used to assess the pain perception at five predefined steps.Instillation of the liquids used for HSG was found (...) ).For effective pain relief during HSG, in addition to 550 mg NSAID, local application of lidocaine cream to the posterior fornix of the cervix uteri and paracervical lidocaine injection into the cervix uteri appear to be the most effective methods.

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2015 Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur Controlled trial quality: uncertain

157. An Evaluation of Oral Midazolam for Anxiety and Pain in First-Trimester Surgical Abortion: A Randomized Controlled Trial. (PubMed)

ibuprofen and a paracervical block. We powered the study (power=80%; significance level=.025) to detect a 15-mm difference in our two a priori primary outcomes of pain and anxiety with uterine aspiration on a 100-mm visual analog scale. Secondary outcomes were pain and anxiety at additional time points, memory, satisfaction, side effects, and adverse events.Demographics were similar between groups (placebo=62, midazolam=62). Compared with those randomized to placebo, patients who received midazolam had

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2015 Obstetrics and Gynecology Controlled trial quality: predicted high

158. Effect of lidocaine spray in pain management during office-based endometrial sampling: A randomised placebo-controlled trial. (PubMed)

Effect of lidocaine spray in pain management during office-based endometrial sampling: A randomised placebo-controlled trial. Office-based endometrial sampling is the most frequently performed gynaecological procedure. The procedure is usually associated with pain and discomfort. Several anaesthetic and analgesic techniques (e.g., non-steroidal anti-inflammatory drugs, paracervical block, misoprostol and topical anaesthetics) are used for pain management during endometrial sampling

2015 Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology Controlled trial quality: predicted high

159. Bipolar versus balloon endometrial ablation in the office: a randomized controlled trial. (PubMed)

Bipolar versus balloon endometrial ablation in the office: a randomized controlled trial. To compare the effectiveness of bipolar radiofrequency (Novasure®) ablation and balloon endometrial ablation (Thermablate®).We performed a multi-center double blind, randomized controlled trial in three hospitals in The Netherlands. Women with heavy menstrual bleeding were randomly allocated to bipolar or balloon endometrial ablation, performed in the office, using a paracervical block. The primary outcome

2015 European journal of obstetrics, gynecology, and reproductive biology Controlled trial quality: predicted high

160. Hydrocodone-acetaminophen for pain control in first-trimester surgical abortion: a randomized controlled trial (PubMed)

(before 11 weeks of gestation) received standard premedication (ibuprofen and lorazepam) and a paracervical block with the addition of 10 mg hydrocodone and 650 mg acetaminophen or placebo 45-90 minutes before surgical abortion. A sample size of 120 was calculated to provide 80% power to show a 15-mm difference (α=0.05) in the primary outcome of pain with uterine aspiration (100-mm visual analog scale). Secondary outcomes were pain at additional time points, satisfaction, side effects, adverse events

2012 EvidenceUpdates Controlled trial quality: predicted high

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