Trial Outcomes & Findings for Buffered Lidocaine for Loop Electrosurgical Excision Procedures (LEEPs) (NCT NCT01405768)

NCT ID: NCT01405768

Last Updated: 2014-07-28

Results Overview

A Likert visual analog scale will be used to document each study participant's level of pain experienced during injection of the cervical block. Within 30 minutes of completion of the procedure and after instruction by the investigators, women reported the intensity of their pain by marking single lines across 100-mm Likert visual analog scales. Scales did not include hashmarks or internal descriptors, as these have been shown to bias responses and diminish reliability. Patient marks on 100-mm Likert scale lines were measured, and a score was determined by the length marked off in millimeters. Patients who wrote "no pain" were considered to have marked 0 mm.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

56 participants

Primary outcome timeframe

Within 30 minutes of completion of procedure

Results posted on

2014-07-28

Participant Flow

Participant milestones

Participant milestones
Measure
Lidocaine Arm
Women in this arm will receive plain lidocaine with epinephrine injected into their cervix prior to the LEEP procedure.
Buffered Lidocaine
Women in this arm will receive sodium bicarbonate buffered lidocaine mixed with epinephrine injected into their cervix prior to the LEEP procedure. sodium bicarbonate buffered lidocaine: 8.4% sodium bicarbonate will be mixed with lidocaine in a 1:10 ratio prior to mixing with epinephrine and injecting into the cervix.
Overall Study
STARTED
28
28
Overall Study
COMPLETED
24
28
Overall Study
NOT COMPLETED
4
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Lidocaine Arm
Women in this arm will receive plain lidocaine with epinephrine injected into their cervix prior to the LEEP procedure.
Buffered Lidocaine
Women in this arm will receive sodium bicarbonate buffered lidocaine mixed with epinephrine injected into their cervix prior to the LEEP procedure. sodium bicarbonate buffered lidocaine: 8.4% sodium bicarbonate will be mixed with lidocaine in a 1:10 ratio prior to mixing with epinephrine and injecting into the cervix.
Overall Study
Didn't complete questionnaire correctly
4
0

Baseline Characteristics

Buffered Lidocaine for Loop Electrosurgical Excision Procedures (LEEPs)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Lidocaine Arm
n=24 Participants
Women in this arm will receive plain lidocaine with epinephrine injected into their cervix prior to the LEEP procedure.
Buffered Lidocaine
n=28 Participants
Women in this arm will receive sodium bicarbonate buffered lidocaine mixed with epinephrine injected into their cervix prior to the LEEP procedure. sodium bicarbonate buffered lidocaine: 8.4% sodium bicarbonate will be mixed with lidocaine in a 1:10 ratio prior to mixing with epinephrine and injecting into the cervix.
Total
n=52 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
24 Participants
n=5 Participants
28 Participants
n=7 Participants
52 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Continuous
32.4 years
STANDARD_DEVIATION 10.3 • n=5 Participants
32.3 years
STANDARD_DEVIATION 7.6 • n=7 Participants
32.4 years
STANDARD_DEVIATION 9.2 • n=5 Participants
Sex: Female, Male
Female
24 Participants
n=5 Participants
28 Participants
n=7 Participants
52 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
African American
13 participants
n=5 Participants
12 participants
n=7 Participants
25 participants
n=5 Participants
Race/Ethnicity, Customized
White
10 participants
n=5 Participants
14 participants
n=7 Participants
24 participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic/Latina
0 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants
Race/Ethnicity, Customized
Other
1 participants
n=5 Participants
1 participants
n=7 Participants
2 participants
n=5 Participants
Region of Enrollment
United States
24 participants
n=5 Participants
28 participants
n=7 Participants
52 participants
n=5 Participants
Parity
0
3 participants
n=5 Participants
6 participants
n=7 Participants
9 participants
n=5 Participants
Parity
1
5 participants
n=5 Participants
7 participants
n=7 Participants
12 participants
n=5 Participants
Parity
2+
16 participants
n=5 Participants
15 participants
n=7 Participants
31 participants
n=5 Participants
Indication
HSIL
8 participants
n=5 Participants
4 participants
n=7 Participants
12 participants
n=5 Participants
Indication
CIN 2
4 participants
n=5 Participants
7 participants
n=7 Participants
11 participants
n=5 Participants
Indication
CIN 3
11 participants
n=5 Participants
15 participants
n=7 Participants
26 participants
n=5 Participants
Indication
AIS
1 participants
n=5 Participants
1 participants
n=7 Participants
2 participants
n=5 Participants
Indication
Persistent CIN 1
0 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants
Procedure type
Ectocervix only
16 participants
n=5 Participants
17 participants
n=7 Participants
33 participants
n=5 Participants
Procedure type
Ectocervix and endocervix
8 participants
n=5 Participants
11 participants
n=7 Participants
19 participants
n=5 Participants
Number of passes
1
6 participants
n=5 Participants
11 participants
n=7 Participants
17 participants
n=5 Participants
Number of passes
2
12 participants
n=5 Participants
12 participants
n=7 Participants
24 participants
n=5 Participants
Number of passes
3+
6 participants
n=5 Participants
5 participants
n=7 Participants
11 participants
n=5 Participants
Ectocervical loop size (in mm)
15 x 12
3 participants
n=5 Participants
7 participants
n=7 Participants
10 participants
n=5 Participants
Ectocervical loop size (in mm)
20 x 12
13 participants
n=5 Participants
16 participants
n=7 Participants
29 participants
n=5 Participants
Ectocervical loop size (in mm)
Other
8 participants
n=5 Participants
5 participants
n=7 Participants
13 participants
n=5 Participants
Endocervical loop size (in mm)
10 x 10
5 participants
n=5 Participants
11 participants
n=7 Participants
16 participants
n=5 Participants
Endocervical loop size (in mm)
15 x 12
2 participants
n=5 Participants
0 participants
n=7 Participants
2 participants
n=5 Participants
Endocervical loop size (in mm)
10 x 8
1 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
Estimated blood loss (in mL)
0 mL
3 participants
n=5 Participants
6 participants
n=7 Participants
9 participants
n=5 Participants
Estimated blood loss (in mL)
1-5 mL
9 participants
n=5 Participants
8 participants
n=7 Participants
17 participants
n=5 Participants
Estimated blood loss (in mL)
6-10 mL
7 participants
n=5 Participants
9 participants
n=7 Participants
16 participants
n=5 Participants
Estimated blood loss (in mL)
>10 mL
5 participants
n=5 Participants
5 participants
n=7 Participants
10 participants
n=5 Participants
Anesthetic volume (in mL)
6-9 mL
12 participants
n=5 Participants
11 participants
n=7 Participants
23 participants
n=5 Participants
Anesthetic volume (in mL)
10 mL
11 participants
n=5 Participants
15 participants
n=7 Participants
26 participants
n=5 Participants
Anesthetic volume (in mL)
>10 mL
1 participants
n=5 Participants
2 participants
n=7 Participants
3 participants
n=5 Participants

PRIMARY outcome

Timeframe: Within 30 minutes of completion of procedure

A Likert visual analog scale will be used to document each study participant's level of pain experienced during injection of the cervical block. Within 30 minutes of completion of the procedure and after instruction by the investigators, women reported the intensity of their pain by marking single lines across 100-mm Likert visual analog scales. Scales did not include hashmarks or internal descriptors, as these have been shown to bias responses and diminish reliability. Patient marks on 100-mm Likert scale lines were measured, and a score was determined by the length marked off in millimeters. Patients who wrote "no pain" were considered to have marked 0 mm.

Outcome measures

Outcome measures
Measure
Lidocaine Arm
n=24 Participants
Women in this arm will receive plain lidocaine with epinephrine injected into their cervix prior to the LEEP procedure.
Buffered Lidocaine
n=28 Participants
Women in this arm will receive sodium bicarbonate buffered lidocaine mixed with epinephrine injected into their cervix prior to the LEEP procedure. sodium bicarbonate buffered lidocaine: 8.4% sodium bicarbonate will be mixed with lidocaine in a 1:10 ratio prior to mixing with epinephrine and injecting into the cervix.
Injection Pain Score (Mean)
25 units on a scale
Standard Deviation 19
19 units on a scale
Standard Deviation 17

PRIMARY outcome

Timeframe: Within 30 minutes of completion of the procedure

A Likert visual analog scale will be used to document each study participant's level of pain experienced during injection of the cervical block. Within 30 minutes of completion of the procedure and after instruction by the investigators, women reported the intensity of their pain by marking single lines across 100-mm Likert visual analog scales. Scales did not include hashmarks or internal descriptors, as these have been shown to bias responses and diminish reliability. Patient marks on 100-mm Likert scale lines were measured, and a score was determined by the length marked off in millimeters. Patients who wrote "no pain" were considered to have marked 0 mm.

Outcome measures

Outcome measures
Measure
Lidocaine Arm
n=24 Participants
Women in this arm will receive plain lidocaine with epinephrine injected into their cervix prior to the LEEP procedure.
Buffered Lidocaine
n=28 Participants
Women in this arm will receive sodium bicarbonate buffered lidocaine mixed with epinephrine injected into their cervix prior to the LEEP procedure. sodium bicarbonate buffered lidocaine: 8.4% sodium bicarbonate will be mixed with lidocaine in a 1:10 ratio prior to mixing with epinephrine and injecting into the cervix.
Injection Pain Score (Median)
26 units on a scale
Interval 0.0 to 75.0
18 units on a scale
Interval 0.0 to 60.0

SECONDARY outcome

Timeframe: Within 30 minutes of completion of procedure

A Likert visual analog scale will be used to determine the overall pain experienced by each study participant including injection pain, procedural pain, and cramping. Within 30 minutes of completion of the procedure and after instruction by the investigators, women reported the intensity of their pain by marking single lines across 100-mm Likert visual analog scales. Scales did not include hashmarks or internal descriptors, as these have been shown to bias responses and diminish reliability. Patient marks on 100-mm Likert scale lines were measured, and a score was determined by the length marked off in millimeters. Patients who wrote "no pain" were considered to have marked 0 mm.

Outcome measures

Outcome measures
Measure
Lidocaine Arm
n=24 Participants
Women in this arm will receive plain lidocaine with epinephrine injected into their cervix prior to the LEEP procedure.
Buffered Lidocaine
n=28 Participants
Women in this arm will receive sodium bicarbonate buffered lidocaine mixed with epinephrine injected into their cervix prior to the LEEP procedure. sodium bicarbonate buffered lidocaine: 8.4% sodium bicarbonate will be mixed with lidocaine in a 1:10 ratio prior to mixing with epinephrine and injecting into the cervix.
Overall LEEP Procedure Pain Including Procedural Pain and Cramping (Mean)
Injection pain
25 units on a scale
Standard Deviation 19
19 units on a scale
Standard Deviation 17
Overall LEEP Procedure Pain Including Procedural Pain and Cramping (Mean)
Procedure pain
27 units on a scale
Standard Deviation 18
19 units on a scale
Standard Deviation 17
Overall LEEP Procedure Pain Including Procedural Pain and Cramping (Mean)
Cramping pain
19 units on a scale
Standard Deviation 16
18 units on a scale
Standard Deviation 16

SECONDARY outcome

Timeframe: Within 30 minutes of completion of procedure

A Likert visual analog scale will be used to determine the overall pain experienced by each study participant including injection pain, procedural pain, and cramping. Within 30 minutes of completion of the procedure and after instruction by the investigators, women reported the intensity of their pain by marking single lines across 100-mm Likert visual analog scales. Scales did not include hashmarks or internal descriptors, as these have been shown to bias responses and diminish reliability. Patient marks on 100-mm Likert scale lines were measured, and a score was determined by the length marked off in millimeters. Patients who wrote "no pain" were considered to have marked 0 mm.

Outcome measures

Outcome measures
Measure
Lidocaine Arm
n=24 Participants
Women in this arm will receive plain lidocaine with epinephrine injected into their cervix prior to the LEEP procedure.
Buffered Lidocaine
n=28 Participants
Women in this arm will receive sodium bicarbonate buffered lidocaine mixed with epinephrine injected into their cervix prior to the LEEP procedure. sodium bicarbonate buffered lidocaine: 8.4% sodium bicarbonate will be mixed with lidocaine in a 1:10 ratio prior to mixing with epinephrine and injecting into the cervix.
Overall LEEP Procedure Pain Including Procedural Pain and Cramping (Median)
Injection pain
26 units on a scale
Interval 0.0 to 75.0
18 units on a scale
Interval 0.0 to 60.0
Overall LEEP Procedure Pain Including Procedural Pain and Cramping (Median)
Procedure pain
25 units on a scale
Interval 0.0 to 63.0
13 units on a scale
Interval 0.0 to 54.0
Overall LEEP Procedure Pain Including Procedural Pain and Cramping (Median)
Cramping pain
19 units on a scale
Interval 0.0 to 62.0
14 units on a scale
Interval 0.0 to 65.0

Adverse Events

Lidocaine Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Buffered Lidocaine

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

L. Stewart Massad, M.D.

Washington University School of Medicine

Phone: 314-362-3181

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place