Evaluation of side effects of intrauterine trans cervical injection of bupivacaine to reduce pain after dilatation and curettage surgery

Used for analgesic control during dilation surgery and curettage under general or local anesthesia or paracervical block. The aim of this study was to evaluate the analgesic effect of bupivacaine intrauterine injection in reducing pain after dilatation and curettage.

In this case series case study, 35 women aged 18-50 years who were candidates for dilatation and elective curettage underwent general anesthesia with sedation. After completion of 25 cc bupivacaine surgery, 0.25% intrauterine injection was inserted into the uterine cavity through a Foley catheter. Heart rate and blood pressure in the recovery unit and 1, 2, 3, 4 hours after surgery, pain intensity based on VAS, heart rate, paresthesia, pruritus and patients' satisfaction with analgesia were recorded.

Transient itching was observed in 3 patients (8.57%) and transient paresthesia was observed in 2 patients (5.7%). Nine patients required 100 mg diclofenac suppository. The mean pain score in the recovery unit was 0.4 and 1 after 4 hours. Heart rate did not change significantly from baseline (p> 0.05). However, mean arterial pressure increased significantly (p = 0.001) at 3 h and decreased significantly at 4 h. (p = 0.03)

Intrauterine bupivacaine injection is an effective tool in controlling pain relief after dilation and curettage. However, it can be associated with side effects.