In-office thermachoice III ablation: a comparison of two anesthetic techniques

Patient comfort and safety are prerequisites for office procedures.

comparison of the fentanyl transdermal patch with injection of local anesthesia for intraoperative/postoperative pain from in-office Thermachoice III ablations.

Single-center prospective randomized (1:1) cohort study. Primary Endpoint: intraoperative and postoperative VAS pain scores (0 as no pain, 10 as extreme pain). Secondary Endpoints: patient satisfaction between cohorts and adverse events.

41 patients were randomized [21 patch protocol (FP), 20 injection protocol (IP)]. For patch users, the median VAS scores were 2.60 (range 1-4) intraoperatively and 3.30 (range 2-5) postoperatively (p = 0.09, CI = -0.8 to 0.4), with the most common adverse events being nausea (62%) and vomiting (38%). Compared to injection, there was no significant difference in intraoperative VAS score (FP median VAS = 2.60, IP median VAS = 2.59; p = 0.15, CI = -0.05 to 0.48), but a significant difference postoperatively (FP median VAS = 3.30, IP median VAS = 6.0; p = 0.01, CI = -2.6 to -1.4). Less NSAIDs were used postoperatively with the FP. At 24 h, more FP patients were 'very satisfied' or 'satisfied' than IP patients.

Patch intraoperative VAS pain scores are comparable to uterine block scores; postoperative VAS pain scores were statistically lower with the FP. FP resulted in more favorable 'satisfaction' rates compared to IP.