Hystroscopic cornual nerve block in operative hysteroscopy: a Randomized controlled trial

Abstract Background Hysteroscopy has become a standard investigation for a lot of gynecological cases and found to be effective in detecting intrauterine pathology and treating it. It is usually performed as an outpatient procedure under either local or no anesthesia. Aim of the Work to assess the anesthetic efficacy of intracornual nerve block versus placebo in reducing pain & discomfort during operative hysteroscopy. Patients and Methods This randomized, double-blind, placebo-controlled study was conducted on 58 patients at the Early Cancer Detection and Endoscopy Unit (Ain Shams university Hospital) after taking Full ethical approval for the study. Patients referred for outpatient hysteroscopy (between march 2018 and December 2018) were informed about the possible role of intracornual nerve block in reducing pain that could be experienced during the procedure, and were asked to participate. Signed informed consent was obtained from all patients who agreed to participate in the study. Results Among the 42 women who underwent successful operative intervention, the visual analogue score for assessment of intra-operative pain was statistically significantly lower in the LA-ICOB group compared to the placebo-ICOB group. In the same context, the number of patients requiring extra analgesia (either as NSAIDs or opioid analgesics) was statistically significantly larger in the placebo-ICOB group compared to the LA-ICOB group. Conclusion This study proved that the use of intracornual nerve block in operative hysteroscopy is both beneficial and effective in reducing pain and discomfort that could associate operative hysteroscopy procedure.