Paracervical Block for Pain Associated With Laminaria Insertion

NCT ID: NCT02454296

Last Updated: 2017-04-14

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

41 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-05-31

Study Completion Date

2015-12-31

Brief Summary

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To assess if paracervical block is effective at reducing discomfort during placement of intracervical laminaria for pre-operative cervical preparation.

Detailed Description

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Pre-operative dilation of the cervix with use of osmotic dilators (e.g. laminaria, dilapan-S) is commonly done prior to pregnancy termination to make the procedure safer. This study seeks to assess whether paracervical blocks are effective at reducing pain associated with placement of laminaria. Secondarily, this study will evaluate if paracervical blocks are effective at reducing overall procedural pain and increasing overall patient satisfaction for the intracervical laminaria placement procedure.

Conditions

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Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Paracervical Block with lidocaine

A paracervical block will be done prior to the placement of laminaria with 1% lidocaine and sodium bicarbonate.

Group Type ACTIVE_COMPARATOR

Paracervical Block with lidocaine

Intervention Type DRUG

Performance of paracervical block, using 18 mL of 1% lidocaine buffered with 2 mL 8.4% sodium bicarbonate, prior to laminaria insertion

Sham paracervical block

A sham block will be done prior to the placement of laminaria using a capped needle

Group Type SHAM_COMPARATOR

Sham paracervical block

Intervention Type DRUG

A capped needle will be placed on the cervix prior to laminaria insertion for purposes of blinding both the participant and research staff assessing outcomes

Interventions

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Paracervical Block with lidocaine

Performance of paracervical block, using 18 mL of 1% lidocaine buffered with 2 mL 8.4% sodium bicarbonate, prior to laminaria insertion

Intervention Type DRUG

Sham paracervical block

A capped needle will be placed on the cervix prior to laminaria insertion for purposes of blinding both the participant and research staff assessing outcomes

Intervention Type DRUG

Other Intervention Names

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Paracervical block Sham block; placebo

Eligibility Criteria

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Inclusion Criteria

* Pregnant women between the ages of 18-49 years
* Desiring surgical termination of pregnancy or surgical management of a fetal demise
* Treatment plan involves cervical preparation with laminaria
* Participant able to provide informed consent in English and willing to participate in the study

Exclusion Criteria

* Unable to read/speak/understand English
* Contraindications to receiving lidocaine
Minimum Eligible Age

18 Years

Maximum Eligible Age

49 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Hawaii

OTHER

Sponsor Role lead

Responsible Party

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Reni Soon

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Principal Investigator

Role: PRINCIPAL_INVESTIGATOR

University of Hawaii

Locations

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University Women's Health Specialists

Honolulu, Hawaii, United States

Site Status

Countries

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United States

References

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Grimes DA, Schulz KF, Cates WJ Jr. Prevention of uterine perforation during curettage abortion. JAMA. 1984 Apr 27;251(16):2108-11.

Reference Type BACKGROUND
PMID: 6708260 (View on PubMed)

Renner RM, Nichols MD, Jensen JT, Li H, Edelman AB. Paracervical block for pain control in first-trimester surgical abortion: a randomized controlled trial. Obstet Gynecol. 2012 May;119(5):1030-7. doi: 10.1097/AOG.0b013e318250b13e.

Reference Type BACKGROUND
PMID: 22525915 (View on PubMed)

Kan AS, Ng EH, Ho PC. The role and comparison of two techniques of paracervical block for pain relief during suction evacuation for first-trimester pregnancy termination. Contraception. 2004 Aug;70(2):159-63. doi: 10.1016/j.contraception.2004.03.013.

Reference Type BACKGROUND
PMID: 15288222 (View on PubMed)

Mercier RJ, Liberty A. Intrauterine lidocaine for pain control during laminaria insertion: a randomized controlled trial. Contraception. 2014 Dec;90(6):594-600. doi: 10.1016/j.contraception.2014.07.008. Epub 2014 Jul 23.

Reference Type BACKGROUND
PMID: 25139724 (View on PubMed)

Borgatta L, Roncari D, Sonalkar S, Mark A, Hou MY, Finneseth M, Vragovic O. Mifepristone vs. osmotic dilator insertion for cervical preparation prior to surgical abortion at 14-16 weeks: a randomized trial. Contraception. 2012 Nov;86(5):567-71. doi: 10.1016/j.contraception.2012.05.002. Epub 2012 Jun 6.

Reference Type BACKGROUND
PMID: 22682721 (View on PubMed)

Drey EA, Benson LS, Sokoloff A, Steinauer JE, Roy G, Jackson RA. Buccal misoprostol plus laminaria for cervical preparation before dilation and evacuation at 21-23 weeks of gestation: a randomized controlled trial. Contraception. 2014 Apr;89(4):307-13. doi: 10.1016/j.contraception.2013.10.013. Epub 2013 Nov 4.

Reference Type BACKGROUND
PMID: 24560477 (View on PubMed)

Goldberg AB, Drey EA, Whitaker AK, Kang MS, Meckstroth KR, Darney PD. Misoprostol compared with laminaria before early second-trimester surgical abortion: a randomized trial. Obstet Gynecol. 2005 Aug;106(2):234-41. doi: 10.1097/01.AOG.0000168629.17326.00.

Reference Type BACKGROUND
PMID: 16055570 (View on PubMed)

Prairie BA, Lauria MR, Kapp N, Mackenzie T, Baker ER, George KE. Mifepristone versus laminaria: a randomized controlled trial of cervical ripening in midtrimester termination. Contraception. 2007 Nov;76(5):383-8. doi: 10.1016/j.contraception.2007.07.008. Epub 2007 Oct 4.

Reference Type BACKGROUND
PMID: 17963864 (View on PubMed)

Hakim-Elahi E, Tovell HM, Burnhill MS. Complications of first-trimester abortion: a report of 170,000 cases. Obstet Gynecol. 1990 Jul;76(1):129-35.

Reference Type BACKGROUND
PMID: 2359559 (View on PubMed)

Blanco LJ, Reid PR, King TM. Plasma lidocaine levels following paracervical infiltration for aspiration abortion. Obstet Gynecol. 1982 Oct;60(4):506-8.

Reference Type BACKGROUND
PMID: 7121936 (View on PubMed)

Soon R, Tschann M, Salcedo J, Stevens K, Ahn HJ, Kaneshiro B. Paracervical Block for Laminaria Insertion Before Second-Trimester Abortion: A Randomized Controlled Trial. Obstet Gynecol. 2017 Aug;130(2):387-392. doi: 10.1097/AOG.0000000000002149.

Reference Type DERIVED
PMID: 28697113 (View on PubMed)

Related Links

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Other Identifiers

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22702

Identifier Type: -

Identifier Source: org_study_id

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