Randomized Controlled Trial of Mefenamic Acid vs Paracervical Block for Relief of Pain for Outpatient Uterine Curettage
Pranom Buppasiri, MD*, Saowanee Tangmanowutikul, MD*, Wilaiwan Yoosuk, BSc (Nursing)**
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University ** Nursing Division, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University
Objective : To compare the efficacy of mefenamic acid vs paracervical block for pain relief during and after
fractional curettage.
Materials and Methods : Between January 1 and July 31, 2002, the authors enrolled 87 patients with abnormal
uterine bleeding, who requested fractional curettage at the Outpatient Gynecologic Clinic, Srinagarind
Hospital, Khon Kaen University. A simple randomization procedure was used to distribute the patients into
a control group comprising 44 patients given a paracervical block and a treatment group comprising 43
patients given mefenamic acid (500 mg) 2 hours before starting the procedure.
Outcome measures: Pain was scored using a visual analogue scale (VAS range, 0 to 10).
Results : The median pain scores of the treatment types during endocervical, endometrial, immediately after,
and 30 minutes after, fractional curettage were 2.5 vs 3.0 (p = 0.42), 6.5 vs 7.5 (p = 0.19), 4.0 vs 3.5 (p = 0.20)
and 1.5 vs 1.0 (p = 0.17), respectively. The rate of complications was 6.8% (3 in 44) in the paracervical
lignocaine injection group.
Conclusion : The efficacy of pain relief for fractional curettage using oral mefenamic acid (500 mg) two hours
before the procedure was not statistically different from the paracervical block, but there were fewer side
effects. Mefenamic acid should be considered an alternate pain relief during fractional curettage.
Keywords : Abnormal uterine bleeding, Fractional curettage, Paracervical block, Mefenamic acid
