Lidocaine spray compared with submucosal injection for reducing pain during loop electrosurgical excision procedure: a randomized controlled trial.

Abstract:

OBJECTIVE:To examine the effectiveness of lidocaine spray compared with conventional lidocaine submucosal injection during a loop electrosurgical excision procedure (LEEP). METHODS:Women undergoing LEEP for any degrees of cervical intraepithelial neoplasia were invited to participate. The participants were randomly assigned into two groups. In group 1 (injection), the participants were anesthetized with 1.8 mL (36 mg) of 2% lidocaine with 1:100,000 epinephrine injected submucosally using a pressure syringe injector with a 27-gauge needle tip at 3, 6, 9, and 12 o'clock locations of the ectocervix. For group 2 (spray), the patients were locally anesthetized with four puffs (40 mg) of 10% lidocaine spray applied thoroughly to the ectocervix. The patients rated their pain according to a 10-cm visual analog scale at different points during the procedure including baseline, postanesthesia, excision, and 30 minutes postexcision. Primary outcomes were the excision pain score and its difference from the baseline. RESULTS:One hundred one patients (51 in the injection group and 50 in the spray group) participated in the study. The baseline pain scores, the excision pain scores, the difference between the excision and the baseline pain scores, and the postexcision pain scores were comparable between the study groups. The median postanesthesia pain score and the median difference of the postanesthesia score from baseline were significantly higher in the injection group, 3.4 compared with 0.6 and 1.9 compared with 0.0, respectively (P<.01). CONCLUSION:Lidocaine spray is an effective and practical alternative measure for reducing pain associated with electrical excision of the cervix during LEEP. CLINICAL TRIAL REGISTRATION:ClinicalTrials.gov, www.clinicaltrials.gov, NCT01505920. LEVEL OF EVIDENCE:I.

journal_name

Obstet Gynecol

authors

Vanichtantikul A,Charoenkwan K

doi

10.1097/AOG.0b013e31829d888e

subject

Has Abstract

pub_date

2013-09-01 00:00:00

pages

553-7

issue

3

eissn

0029-7844

issn

1873-233X

journal_volume

122

pub_type

杂志文章,随机对照试验
  • Atrial fibrillation in pregnancy.

    abstract:BACKGROUND:Physiologic changes of pregnancy can predispose women to cardiac arrhythmias. Atrial fibrillation is rare in pregnancy and usually occurs in women with underlying cardiac anomalies. CASE:A young woman at 22 weeks of gestation presented with new-onset atrial fibrillation with rapid ventricular response. Thor...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e31820561ef

    authors: DiCarlo-Meacham LA,Dahlke LJ

    更新日期:2011-02-01 00:00:00

  • Estradiol, estrone, and gonadotropin levels after use of vaginal estradiol.

    abstract::The vaginal absorption of 0.5-mg tablets of micronized estradiol was evaluated in postmenopausal women. In a single-dose study, one hour after insertion, a 5.3-fold rise in mean serum estradiol levels and 1.5-fold rise in mean serum estrone levels were observed. Mean levels of luteinizing hormone and follicle-stimulat...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Martin PL,Greaney MO,Burnier AM,Brooks PM,Yen SS,Quigley ME

    更新日期:1984-04-01 00:00:00

  • A paired controlled study of vaginal and abdominal delivery of the low birth weight breech fetus.

    abstract::In a paired, controlled, retrospective study, 44 low birth weight breech fetuses delivered vaginally were compared with 44 breech fetuses delivered by cesarean section. Seven deaths occurred in the vaginal delivery group, compared with only 1 in the abdominal delivery group. Asphyxia, trauma, and intracranial hemorrha...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Duenhoelter JH,Wells CE,Reisch JS,Santos-Ramos R,Jimenez JM

    更新日期:1979-09-01 00:00:00

  • DES-related clear cell adenocarcinoma of the vagina in pregnancy.

    abstract::The occurrence of diethylstilbestrol- (DES)-related clear cell adenocarcinoma of the vagina in a pregnant patient who carried the pregnancy to term is reported. The tumor, observed directly over an extended period, did not appear to be influenced by elevated plasma estrogen levels during pregnancy. Problems of diagnos...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Jones WB,Woodruff JM,Erlandson RA,Lewis JL Jr

    更新日期:1981-06-01 00:00:00

  • Cervical Cerclage During Periviability: Can We Stabilize a Moving Target?

    abstract::The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine recently published consensus guidelines on periviable birth recommending that obstetric interventions (antenatal corticosteroids, tocolysis, magnesium sulfate, antibiotics for preterm premature rupture of membranes or g...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000001391

    authors: Dahlke JD,Sperling JD,Chauhan SP,Berghella V

    更新日期:2016-05-01 00:00:00

  • Recurrence of group B streptococci colonization in subsequent pregnancy.

    abstract:OBJECTIVE:To estimate the prevalence of group B streptococci (GBS) colonization in a subsequent pregnancy in women with and without GBS colonization in an index pregnancy. METHODS:A retrospective cohort study of women who had two consecutive deliveries with the availability of GBS culture result at 35 to 37 weeks of g...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e31817f5cb9

    authors: Turrentine MA,Ramirez MM

    更新日期:2008-08-01 00:00:00

  • Neonatal outcomes after gestational exposure to nitrofurantoin.

    abstract:OBJECTIVE:To estimate whether first-trimester exposure to nitrofurantoin is associated with increased malformation rates and, secondarily, to estimate whether exposure to nitrofurantoin is associated with increased rates of negative pregnancy outcomes and perinatal complications. METHODS:We conducted a population-base...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e31827c5f88

    authors: Nordeng H,Lupattelli A,Romøren M,Koren G

    更新日期:2013-02-01 00:00:00

  • Antimüllerian hormone as a predictor of natural fecundability in women aged 30-42 years.

    abstract:OBJECTIVE:To generate estimates of the association between markers of ovarian aging and natural fertility in a community sample at risk for ovarian aging. METHODS:Women aged 30-44 years with no history of infertility who had been trying to conceive for less than 3 months provided early-follicular phase serum and urine...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e3182116bc8

    authors: Steiner AZ,Herring AH,Kesner JS,Meadows JW,Stanczyk FZ,Hoberman S,Baird DD

    更新日期:2011-04-01 00:00:00

  • Impact of psychodynamic factors on the course and management of patients with pseudocyesis.

    abstract::Comparing and contrasting two patients with pseudocyesis made it clear that differing psychodynamic factors specific to each patient resulted in divergent ways in which they sought out and used medical care. The propensity of these patients to distort reality was observed to interfere with the usefulness of sonography...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Starkman MN

    更新日期:1984-07-01 00:00:00

  • Postoperative pain after local anesthetics for laparoscopic sterilization.

    abstract:OBJECTIVE:To test the effectiveness of intraperitoneal local anesthesia in relieving postoperative pain after laparoscopic sterilization. METHODS:In a double-blind, placebo-controlled randomized study of two groups of 25 subjects each, women scheduled for tubal sterilization under general anesthesia received 80 mL of ...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Benhamou D,Narchi P,Mazoit JX,Fernandez H

    更新日期:1994-11-01 00:00:00

  • Hemoglobin SD disease associated with cholecystitis and cholelithiasis in pregnancy.

    abstract::A black multipara was shown, by hemoglobin electrophoresis, to have hemoglobin SD disease. The patient exhibited a typically mild anemia that probably was secondary to folate and iron deficiencies as well as to hemoglobinopathic hemolysis. The course of her pregnancy was complicated by pyelonephritis and hyposthenuria...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Spinapolice RX,Colmorgen GH,Spisso K

    更新日期:1982-09-01 00:00:00

  • Maternal serum levels of placental protein 5 in complications of late pregnancy.

    abstract::Maternal serum levels of placental protein 5 (PP5) were measured during the third trimester in women with normal and abnormal pregnancies. PP5 levels were significantly elevated in patients with preeclampsia, diabetes, intrauterine growth retardation associated with preeclampsia, and twin pregnancy. ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Salem HT,Westergaard JG,Hindersson P,Lee JN,Grudzinskas JG,Chard T

    更新日期:1982-04-01 00:00:00

  • Medical liability reform: a case study of Mississippi.

    abstract::Mississippi enacted medical negligence and other tort reform legislation that generally became effective for causes of action filed on or after January 1, 2003, and September 1, 2004. Data regarding lawsuits against physicians insured by the Medical Assurance Company of Mississippi (MACM), the largest medical liabilit...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e318226ba47

    authors: Behrens MA

    更新日期:2011-08-01 00:00:00

  • The significance of fetal heart rate reactivity with a positive oxytocin challenge test.

    abstract::This study reviews 27 patients with positive OCTs who were subsequently allowed a trial of directly monitored labor. Of these, 19 patients (70%) developed FHR signs of fetal distress and 8 (30%) tolerated labor without late decelerations. These patients were evaluated for signs of fetal reactivity (acceleration of the...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Braly P,Freeman RK

    更新日期:1977-12-01 00:00:00

  • Endometriosis and body fat distribution.

    abstract:OBJECTIVE:To examine the association of body fat distribution with risk of endometriosis in an effort to determine whether a specific somatotype is related to the disease. METHODS:We conducted a case-control study of 88 laparoscopically confirmed cases of endometriosis, identified in a specialty gynecologic practice i...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: McCann SE,Freudenheim JL,Darrow SL,Batt RE,Zielezny MA

    更新日期:1993-10-01 00:00:00

  • Evaluation of preterm delivery in a systemic lupus erythematosus pregnancy clinic.

    abstract:OBJECTIVE:To identify the primary etiology of preterm birth in women with systemic lupus erythematosus, analyzing prospective data collected on 66 pregnancies in 58 women followed-up at a lupus pregnancy center. METHODS:Hospital records were reviewed and subjects were interviewed for pregnancies delivered after 23 com...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0029-7844(95)00186-U

    authors: Johnson MJ,Petri M,Witter FR,Repke JT

    更新日期:1995-09-01 00:00:00

  • False alarms and pseudo-epidemics: the limitations of observational epidemiology.

    abstract::Most reported associations in observational clinical research are false, and the minority of associations that are true are often exaggerated. This credibility problem has many causes, including the failure of authors, reviewers, and editors to recognize the inherent limitations of these studies. This issue is especia...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e31826af61a

    authors: Grimes DA,Schulz KF

    更新日期:2012-10-01 00:00:00

  • The limited usefulness of urine and blood cultures in treating pyelonephritis in pregnancy.

    abstract::Although urine cultures are performed routinely in managing acute pyelonephritis in pregnancy, little is known about the clinical usefulness of these cultures. The same is true for blood cultures. To evaluate their role in managing patients, we reviewed the records of 156 cases to determine to what extent such culture...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: MacMillan MC,Grimes DA

    更新日期:1991-11-01 00:00:00

  • Risk factors for lower urinary tract symptoms in women 40 to 60 years of age.

    abstract:OBJECTIVE:To determine the relationship between lower urinary tract symptoms and possible associated risk factors in women 40-60 years old. METHODS:In a normal population study, 502 women with lower urinary tract symptoms and 742 women with no symptoms (controls) were asked about possible associated factors. RESULTS:...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Alling Møller L,Lose G,Jørgensen T

    更新日期:2000-09-01 00:00:00

  • Prognostic factors for outcome of and survival after second-look laparotomy in patients with advanced ovarian carcinoma.

    abstract::In ovarian cancer stages IIB-IV, pre-treatment variables and variables obtained intraoperatively at second-look laparotomy were investigated for their prognostic influence on the outcome of 109 patients and survival after second-look laparotomy in 131 patients. The subjects came from a randomized trial of sequential v...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Lund B,Williamson P

    更新日期:1990-10-01 00:00:00

  • Fetal biometry as a screening tool for the detection of chromosomally abnormal pregnancies.

    abstract::Recent studies suggest that fetal biometry may allow recognition of pregnancies at risk for Down syndrome. Second-trimester biparietal diameter (BPD)/femur length and observed-to-expected femur length ratios were examined in 48 chromosomally abnormal fetuses and compared with those of a control population composed of ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Dicke JM,Gray DL,Songster GS,Crane JP

    更新日期:1989-11-01 00:00:00

  • Hand-held computer operating system program for collection of resident experience data.

    abstract:OBJECTIVE:To describe a system for recording resident experience involving hand-held computers with the Palm Operating System (3 Com, Inc., Santa Clara, CA). PROGRAM DESCRIPTION:Hand-held personal computers (PCs) are popular, easy to use, inexpensive, portable, and can share data among other operating systems. Residen...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(00)01015-2

    authors: Malan TK,Haffner WH,Armstrong AY,Satin AJ

    更新日期:2000-11-01 00:00:00

  • A trial of prophylactic cefamandole in extended gynecologic surgery.

    abstract::A double-blind randomized trial of antibiotic prophylaxis was performed with 49 patients undergoing extended pelvic surgery for adenocarcinoma of the endometrium. In this series infections of the Hemovac drain site(s) were most common (8 of 10 infections); only 1 serious infection, pelvic cellulitis, occurred. Short-t...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Creasman WT,Hill GB,Weed JC Jr,Gall SA

    更新日期:1982-03-01 00:00:00

  • Interpreting the literature in obstetrics and gynecology: II. Logistic regression and related issues.

    abstract::The goal of epidemiology is accurate measure of the relationship between an exposure and a disease of interest. The control of covariates of the exposure-disease relationship is required to obtain a valid measure. Two types of covariates, confounders and effect modifiers, must be considered. Investigators can design s...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:

    authors: Peterson HB,Kleinbaum DG

    更新日期:1991-10-01 00:00:00

  • Dual-Force Vaginoplasty for Treatment of Segmental Vaginal Aplasia.

    abstract:BACKGROUND:Vaginal aplasia occurs in 1 in 5,000-10,000 female live births. In this report, we evaluated a novel dual-force vaginoplasty technique for treatment of 11 patients with segmental vaginal aplasia. TECHNIQUE:The principle of the approach is to thin the atretic part between two counteracting forces. The instru...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000001974

    authors: El Saman AM,Farag MA,Shazly SA,Noor M,Ali MK,Othman ER,Khalifa M,Farghly TA,El Saman DA

    更新日期:2017-05-01 00:00:00

  • Temporal Trends of Urogynecologic Mesh Reports to the U.S. Food and Drug Administration.

    abstract:OBJECTIVE:To compare temporal trends of urogynecologic mesh medical device reports with sentinel U.S. Food and Drug Administration (FDA) notices and to examine all linked reports of patient death. METHODS:The Reed Tech Navigator is an online tool used to extract and analyze data in the Manufacturer and User Facility D...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000003805

    authors: Sassani JC,Artsen AM,Moalli PA,Bradley MS

    更新日期:2020-05-01 00:00:00

  • Cardiac compliance in fetuses of diabetic women.

    abstract:OBJECTIVE:To examine possible changes in cardiac function in fetuses of pregestational diabetic mothers. METHODS:We conducted a prospective longitudinal study of 31 women whose pregnancies were between 22 weeks' gestation and term, and who had pregestational diabetes. All diabetic women included in the study had glyco...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(99)00003-4

    authors: Weiner Z,Zloczower M,Lerner A,Zimmer E,Itskovitz-Eldor J

    更新日期:1999-06-01 00:00:00

  • Interbirth interval with frequency of cesarean delivery.

    abstract:OBJECTIVE:To estimate whether and to what extent interbirth interval is associated with cesarean delivery. METHODS:This is a retrospective cohort study of 2,528 multiparous women who presented to labor and delivery at a single tertiary care obstetric hospital during an 18-month period. Women were grouped by their inte...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e31821c4368

    authors: Miller ES,Grobman WA

    更新日期:2011-07-01 00:00:00

  • Recurrent vulvovaginal candidiasis associated with long-term tamoxifen treatment in postmenopausal women.

    abstract:BACKGROUND:Symptomatic vulvovaginal candidiasis is rare in postmenopausal subjects because of the estrogen-dependence of this infection. Tamoxifen, a breast-cancer cell estrogen-antagonist, has not previously been reported to predispose to vulvovaginal candidiasis. CASES:Three postmenopausal women, age range 60-81 yea...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0029-7844(96)00123-8

    authors: Sobel JD,Chaim W,Leaman D

    更新日期:1996-10-01 00:00:00

  • Indomethacin and antibiotics in examination-indicated cerclage: a randomized controlled trial.

    abstract:OBJECTIVE:To evaluate whether perioperative indomethacin and antibiotic administration at the time of examination-indicated cerclage placement prolongs gestation. METHODS:This is a randomized controlled trial performed at a single tertiary care hospital between March 2010 and November 2012. Women older than 18 years o...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/AOG.0000000000000228

    authors: Miller ES,Grobman WA,Fonseca L,Robinson BK

    更新日期:2014-06-01 00:00:00