ASSESSMENT OF THE EFFICACY OF PARA CERVICAL BLOCK IN CONJUNCTION WITH CONSCIOUS SEDATION ON PAIN CONTROL DURING OUTPATIENT HYSTEROSCOPY

Background and Objective: Hysteroscopy is considered as very important in the investigation of abnormal uterine bleeding. It is usually performed as an outpatient procedure under either local or no anesthesia. This study was designed to compare the combination of paracervical block (PCB) and conscious sedation with paracervical block or conscious sedation alone for outpatient hysteroscopy in terms of pain control and patient satisfaction. Methods: A total of 60 women with abnormal uterine bleeding were considered eligible for the study. Patients were randomized into three groups. Group A (20 patients) underwent diagnostic hysteroscopy with conscious sedation, in group B (20 patients) paracervical block was performed, and group C (20 patients) received both conscious sedation and paracervical block. Main outcome measures were pain control during the procedure, the postoperative pain score at 15 min, 60 min, and 24 h after the procedure, and patient's satisfaction rate. Results: There were significant differences between combination therapy with other groups in terms of pain control during the procedure (paracervical block plus sedation versus the other two groups: p<O.OO 1 ), and in postoperative pain at different intervals (group C versus A and B groups,p<O. 001 ). Satisfaction rate in group C patients was higher than the other patients (paracervical block+ sedation versus group A and B,p<O.OOl ). Conclusion: Both paracervical block and conscious sedation anesthesia can be used for diagnostic hysteroscopy, but their combination resulted in improved analgesia both during the procedure and postoperative pain and patient satisfaction compared with monotherapy.