Pain-management-during-endometrial-ablation-in-the-office

Pain management during endometrial ablation in the office
Abstract ID : 1603
Soumis par : Marlies Bongers Le 2016-03-11 11:49:23
Nom de la catégorie : SEUD CONGRESS
Typologie : Communication orale / Oral communication
Statut : validé
Autorisation de diffusion : Yes/Oui
------------------------------------Abstract
Objective: To reduce pain during endometrial ablation in the office.
Study design: We performed a pilot study to improve pain score after a multi-center double blind, randomized controlled
trial.
Method: The RCT we performed included 104 women randomized into the bipolar (52) and balloon (52) groups. The
mean visual analog pain score of the total procedure was 7.1 in the bipolar group and 7.4 in the balloon group (P<.577).
A pilot study of 10 patients with improved cervical anesthesia (ropivacaine instead of prilocaine) with or without fundal
anesthesia (prilocaine) was started to reduce the mean visual analog pain score.
Results: Results of the RCT showed amenorrhea rates after 12 months of 56% (29/52) in the bipolar group and 23%
(12/52) in the balloon group (relative risk (RR) 0.6, 95% confidence interval (CI) 0.4 to 0.8). The Shaw score, expressing
quality of life, improved over time (P<.001) and was significantly higher in the bipolar group at 12 months follow-up
(P=.025). The pilot study showed a mean visual analog pain score of 3.7 in the group with fundal injection and 3.8
without fundal injection.
Conclusion: In the treatment of heavy menstrual bleeding, bipolar radiofrequency endometrial ablation is superior to
balloon endometrial ablation as an office procedure in amenorrhea rate, patient satisfaction and quality of life, however
pain management has to be improved. A RCT has been started to evaluate effectiveness of adding fundal anesthesia
besides cervical anesthesia with ropivacaine.
------------------------------------Mots clefs : endometrial ablation, local anesthesia, pain
Auteurs :
Références : , , ,
Auteurs
Marlies Bongers 1, Imke Reinders 1, Josien Penninx 1,
1. Ob/Gyn, Maxima Medical Centre, Veldhoven, NETHERLANDS
Auteurs (raw format)
Bongers Marlies - email : [email protected] Etablissement : Maxima Medical Centre Service : Ob/Gyn Ville :
Veldhoven Pays : NETHERLANDS Présentateur : Oui
Reinders Imke - email : [email protected] Etablissement : Maxima Medical Centre Service : Ob/Gyn Ville : Veldhoven
Pays : NETHERLANDS Présentateur : Non
Penninx Josien - email : [email protected] Etablissement : Maxima Medical Centre Service : Ob/Gyn Ville : Veldhoven
Pays : NETHERLANDS Présentateur : Non