Paracervical block diminishes cramping associated with cryosurgery

Area of Science:

• Gynecology
• Surgical Procedures
• Pain Management

Background:

• Cervical intraepithelial neoplasia (CIN) treatment choices depend on lesion size, operator comfort, cost, and patient comfort.
• Cryosurgery is a common CIN treatment, often associated with patient discomfort.

Purpose of the Study:

• To compare the efficacy of standard cryosurgery versus cryosurgery with a paracervical block in reducing pain and cramping.
• To evaluate patient-reported outcomes for pain and cramping during cryosurgery for CIN.

Main Methods:

• A prospective trial involving 85 women undergoing cryosurgery for CIN.
• Participants received naproxen sodium; 40 had standard cryosurgery, and 45 received a paracervical block prior to the procedure.
• Pain and cramping were assessed using a visual analog scale and analyzed with various statistical tests.

Main Results:

• Cryosurgery with a paracervical block significantly reduced cramping after the first freeze compared to standard cryosurgery (P = .014).
• Overall cramping, including injection discomfort, was significantly less with the paracervical block (P = .019).
• The paracervical block did not significantly decrease perceived pain during the cryosurgery procedure.

Conclusions:

• A paracervical block is an effective method for reducing cramping associated with cryosurgery for cervical intraepithelial neoplasia.
• While effective for cramping, paracervical blocks do not appear to reduce the pain of cryosurgery itself.