Effectiveness of Paracervical Block versus Intravenous Morphine during Uterine Curettage: A Randomized Controlled Trial
Piyathida Thongrong MD*, Phanida Jarruwale MD*, Prisana Panichkul MD*
Affiliation : * Department of Obstetrics and Gynecology, Phramongkutklao Hospital, Bangkok, Thailand
Background : Abnormal uterine bleeding is a common gynecologic problem. Fractional curettage, evacuation and curettage,
and dilatation curettage are common gynecologic procedures for investigation and treatment of abnormal uterine bleeding.
To perform all these procedures, anesthesia is needed but technique varies among hospitals. The standard procedure of
uterine curettage was performed after paracervical block or intravenous morphine injection.
Objective : To compare pain scores during and after uterine curettage using intravenous morphine versus paracervical
block.
Material and Method: A randomized controlled trial study was performed. Sixty-four patients with abnormal uterine
bleeding and indication for curettage were enrolled in the present study. Simple randomized procedure was used to distribute
the patients into two groups. Intravenous morphine was carried out in 32 patients as the group A while paracervical block
was used in the other 32 patients of the group B before uterine curettage. The main outcome measurement was pain score,
which assessed by Numerical rating scale ranging from 0-10.
Results : The median pain score during uterine curettage were 7.5 and 6 (p = 0.103), immediately after uterine curettage were
3 and 3 (p = 0.822) and 30 minutes after uterine curettage were 1 and 1 (p = 0.206) in the control and treatment group,
respectively.
Conclusion : Pain scores in patients who received paracervical block were not statistically different from those who received
intravenous morphine. Paracervical block could be used as another choice for pain relief during uterine curettage.
Keywords : Abnormal uterine bleeding, Paracervical block, Morphine
