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Local anaesthesia during endometrial ablation: a systematic review
Ima Reinders1, Pmaj Geomini1, A Timmermans2
1Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, The Netherlands.
BJOG : an International Journal of Obstetrics and Gynaecology
|December 25, 2016
Summary
Endometrial ablation using local anesthesia is safe and acceptable. Combining intracervical or paracervical blocks with intrauterine injections significantly reduces pain, though more research is needed.
Area of Science:
- Gynecology
- Surgical Anesthesia
Background:
- Endometrial ablation is common in outpatient settings.
- Various local anesthesia protocols exist, but evidence is limited.
- Prospective studies are scarce.
Purpose of the Study:
- To systematically review local anesthesia techniques for endometrial ablation.
- To evaluate their effectiveness in managing pain perception.
Main Methods:
- Systematic literature search of Medline and Embase databases.
- Inclusion of studies with >=10 women undergoing endometrial ablation under local anesthesia.
- Extraction of data on procedures, anesthesia protocols, pain, and side effects.
Main Results:
- Twenty-five studies involving 2013 women were analyzed.
- Combined intra-/paracervical and intrauterine anesthesia showed significantly lower pain scores (low evidence quality).
- High acceptability (77-94%) of endometrial ablation under local anesthesia was reported.
Conclusions:
- Endometrial ablation under local anesthesia is safe, feasible, and well-accepted.
- Combined anesthesia techniques appear promising for pain management.
- Further rigorous investigation of combined techniques is warranted.
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