Intra-uterine bupivacaine and levobupivacaine

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.

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.

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).

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