Phittayawechwiwat Wilaiporn, Thanantaseth Chalermsri, Ayudhya Nathpong Israngura Na, O-Prasertsawat Pratak, Kongprasert Jitlada
Department of Obstetrics and Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Rama IV Rd, Rachatavee, Bangkok 10400, Thailand.
J Med Assoc Thai. 2007 Jun;90(6):1053-7.
To compare the efficacy of oral etoricoxib and placebo combined with paracervical block for pain relief during fractional curettage
A double-blind, randomized controlled trial that included 220 women who underwent fractional curettage and received paracervical block for pain relief was done at Ramathibodi Hospital between September 2005 and June 2006. One hundred and ten women were randomly allocated to the etoricoxib group (90 mg, tablet) and 110 to the placebo group. The main outcome was the patient's assessment of intensity of pain measured by verbal rating scales after speculum insertion, during fractional curettage, immediately after curettage, and 30 minutes after curettage.
Demographic data including age, previous vaginal deliveries, and history of curettage were not significantly different between etoricoxib group and placebo group. Most common indication for fractional curettage was menometrorrhagia in both groups. Pain score in etoricoxib group was significant lower during fractional curettage (5 vs. 6, p = 0.04), immediately after curettage (2 vs. 3, p = 0. 009), and 30 minutes after curettage (0 vs. 1, p = 0.003). Comparing the number of patients with mild pain (score 0-3), there were significant higher number of mild pain patient at the time during curettage (39 vs. 20 cases), immediate after curettage (78 vs. 60 cases), and 30 minutes after curettage (107 vs. 100 cases) in etoricoxib group.
Combination of etoricoxib with paracervical block for reduction of pain during fractional curettage had statistically significant lower pain scale when compared with placebo with paracervical block. However the difference was small and may have questionable clinical significance.
比较口服依托考昔与安慰剂联合宫颈旁阻滞在分段刮宫术中缓解疼痛的疗效
2005年9月至2006年6月在拉玛蒂博迪医院进行了一项双盲随机对照试验,纳入220例行分段刮宫术并接受宫颈旁阻滞以缓解疼痛的女性。110名女性被随机分配至依托考昔组(90毫克,片剂),110名被分配至安慰剂组。主要结局是患者在阴道窥器插入后、分段刮宫术中、刮宫术后即刻以及刮宫术后30分钟通过视觉模拟评分法对疼痛强度的评估。
依托考昔组和安慰剂组的人口统计学数据,包括年龄、既往阴道分娩史和刮宫史,无显著差异。两组分段刮宫术最常见的指征均为月经过多。依托考昔组在分段刮宫术中(5分对6分,p = 0.04)、刮宫术后即刻(2分对3分,p = 0.009)以及刮宫术后30分钟(0分对1分,p = 0.003)的疼痛评分显著更低。比较轻度疼痛(评分0 - 3分)患者数量,依托考昔组在刮宫术中(39例对20例)、刮宫术后即刻(78例对60例)以及刮宫术后30分钟(107例对100例)的轻度疼痛患者数量显著更多。
与安慰剂联合宫颈旁阻滞相比,依托考昔联合宫颈旁阻滞在分段刮宫术中减轻疼痛方面,疼痛量表评分在统计学上显著更低。然而差异较小,可能具有可疑的临床意义。