Bupivacaine Injection for Uterine Conditions
Trial Summary
What is the purpose of this trial?
Hysteroscopy is a minimally invasive, diagnostic and therapeutic gynecological surgical technique and the gold standard in the study of the uterine cavity. Thanks to the decrease in the diameter of hysteroscopes and to the vaginoscopic approach, anesthesia is no longer necessary in diagnostic hysteroscopy. Nevertheless, in operative hysteroscopy, given the instrumentalization and the need of cervical dilation, the use of local anesthesia, with or without sedation, is recommended. The different alternatives described in the literature are the following: 1. Cervical/ intracervical block: injection of local anesthetic into the four quadrants of the cervix. 2. Paracervical block: injection of local anesthetic in the cervicovaginal junction at 5 and 7 o'clock positions. 3. Transcervical (uterine) anesthesia: instillation of a local anesthetic agent via catheter through the cervix and into the uterine cavity. 4. Topical cervical anesthesia: application of local anesthetic in gel or spray to the cervix. To assess the best anesthetic pathway to decrease pain during outpatient hysteroscopy, the investigators will perform a prospective multicentric study that compare two types of local anesthesia in outpatient procedural hysteroscopy: paracervical block, that is the actual gold-standard, and transcervical instillation.
Eligibility Criteria
This trial is for women over 18 who need an outpatient surgical hysteroscopy to remove polyps or fibroids. It's not suitable for those under 18, unable to rate pain on a visual scale, with contraindications to hysteroscopy, or conditions making outpatient procedures unsafe.Inclusion Criteria
Exclusion Criteria
Treatment Details
Interventions
- Paracervical Block (Local Anesthesia)
- Transcervical Block (Local Anesthesia)