Intra-uterine bupivacaine and levobupivacaine

Abstract

Aim: The study aimed to compare the effect of intrauterine bupivacaine and levobupivacaine with placebo in reducing the post-procedure discomfort owing to pain caused by suction endometrial sampling.

Methods: This study was conducted on randomly selected 45 women with abnormal uterine bleeding and who had undergone outpatient hysteroscopy and endometrial biopsy under sedation with propofol 0.5 mg/kg. The study was performed using 5 mL of bupivacaine 0.5% (Group B, n = 15) or levobupivacaine 0.5% (Group L, n = 15) or placebo solution (Group C, n = 15) intrauterine via a catheter over a 5 min period after suction endometrial sampling. The number of patients with visual analogue scale >3, total postoperative analgesic requirements, satisfaction of patients and adverse events were measured. Nonparametric and parametric data were analysed using Kruskal-Wallis and one-way anova tests respectively.

Results: Women in Groups L and B had statistically significantly less pain than the women in Group C (P = 0.03). When compared with placebo, five ml of bupivacaine 0.5% and levobupivacaine 0.5% respectively were recorded to decrease the incidence of postoperative analgesic consumption from 41 to 35% (P = 0.01). The satisfaction score of the patients in Group L was significantly higher than that of the patients in Group C (P = 0.03).

Conclusion: Intrauterine levobupivacaine or bupivacaine is effective in decreasing the pain associated with the endometrial biopsy and curettage under propofol sedation.