Decreasing Postoperative Pain Following Endometrial Ablation

Jordan Klebanoff, Nima R. Patel and Matthew K. Hoffman

Department of Obstetrics & Gynecology, Christiana Care Health System, USA
Division of Minimally Invasive Gynecology, Christiana Care Health System, USA

^*Correspondance to: Jordan Klebanoff 

 PDF  Full Text DOI: 10.25107/2474-1647.1414

Abstract

Objective: We sought to determine if paracervical injection of local anesthesia decreases postoperative pain in women undergoing endometrial ablation under general anesthesia.Design: We performed a retrospective cohort study of consecutive women who had a secondgeneration (Radiofrequency Ablation (RFA), Hydrothermablation (HTA) or Thermachoice II (UBA)) endometrial ablation for benign indications under general anesthesia. Our primary outcome was postoperative pain at 1 h assessed using a validated 10-point visual analog scale (VAS). Our primary exposure was injection of local anesthetic as a paracervical block. Secondary outcomes included immediate postoperative pain, postoperative pain at discharge, amount of postoperative narcotics, and need for anti-emetics.Setting: Single academic affiliated community hospital.Patients: Our study included 124 women who underwent second-generation endometrial ablation between August 2015 and October 2015 at a single institution.Intervention: Paracervical block following second-generation endometrial ablation.Results: Device distribution was as follows: 93 RFA (75%), 26 HTA (21%), and 5 Thermachoice II ablations (4%). 82 women (66%) received a paracervical block immediately following completion of the ablation. Comparing those women who received a paracervical block with those that did not, there was no statistically significant difference for immediate postoperative pain (median=0 vs. 0, p=0.26), postoperative pain at 1 hour (median=2 vs. 2, p=0.42), or pain at time of discharge (median=3 vs. 2 respectively, p=0.77). Mean amount of postoperative morphine required was 5.1 mg for women with no paracervical block versus 5.2 mg for women receiving a paracervical block (p=0.52).Conclusion: Local anesthesia in addition to general anesthesia does not confer any significant reduction in postoperative pain following endometrial ablation, nor does it reduce the amount of narcotic administered.

Keywords

Endometrial ablation; Hydrothermablation; Radiofrequency Ablation; Local anesthesia

Cite the article

Klebanoff J, Patel NR, Hoffman MK. Decreasing Postoperative Pain Following Endometrial Ablation. Clin Surg. 2017; 2: 1414.