A randomized, placebo-controlled, double-blind study of hysteroscopic-guided pertubal diluted bupivacaine infusion for endometriosis-associated chronic pelvic pain

• Published in: International journal of gynecology and obstetrics 2015-09, Vol.130 (3), p.219-222
• Main Authors: Shokeir, Tarek, Mousa, Sherif
• Format: Article
• Language: English
• Subjects: Adult; Anesthetics, Local - administration & dosage; Bupivacaine; Bupivacaine - administration & dosage; Chronic Pain - drug therapy; Chronic Pain - etiology; Double-Blind Method; Egypt; Endometriosis; Endometriosis - complications; Female; Follow-Up Studies; Hospitals, University; Humans; Hysteroscopy; Hysteroscopy - methods; Obstetrics and Gynecology; Pain Measurement; Patient Satisfaction; Pelvic pain; Pelvic Pain - drug therapy; Pelvic Pain - etiology; Surveys and Questionnaires; Time Factors
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/j.ijgo.2015.03.043

Abstract Objective To assess the effectiveness of hysteroscopic-guided pertubal diluted bupivacaine infusion for endometriosis-associated chronic pelvic pain (CPP). Methods Between June 2010 and July 2013, a randomized, placebo-controlled, double-blind study was undertaken at Mansoura University Hospital, Mansoura, Egypt. Patients meeting inclusion criteria (laparoscopically confirmed endometriosis, patent fallopian tubes, ≥ 6 months CPP, pain score on visual analogue scale [VAS] > 5) were randomly assigned using a computer-generated randomization sequence to receive either office hysteroscopic-guided pertubal diluted bupivacaine infusion (0.25%) or placebo. Response to treatment was assessed using subjective data for scores on VAS and a monthly verbal rating scale (VRSmonthly ) at baseline and at 1, 2, and 3 months of follow-up. Additionally, women completed a questionnaire to evaluate the overall satisfaction at 3 months. Results Thirty patients were assigned to each group. In the bupivacaine group, VAS and VRSmonthly scores were significantly lower at 1, 2, and 3 months than at baseline ( P < 0.05 for all). Additionally, scores were significantly lower in the bupivacaine group than in the placebo group at 1, 2, and 3 months ( P < 0.05 for all). At 3 months, 22 (73%) women in the bupivacaine group expressed satisfaction, compared with 2 (7%) in the placebo group ( P = 0.18). Conclusion Office pertubal hysteroscopic-guided diluted bupivacaine infusion could be used to manage endometriosis-associated CPP for at least 3 months. AEARCTR-0000573