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Vaginal lidocaine

Arne Ohlsson, Prakeshkumar S Shah
BACKGROUND: Newborn infants have the ability to experience pain. Hospitalised infants are exposed to numerous painful procedures. Healthy newborns are exposed to pain if the birth process consists of assisted vaginal birth by vacuum extraction or by forceps and during blood sampling for newborn screening tests. OBJECTIVES: To determine the efficacy and safety of paracetamol for the prevention or treatment of procedural/postoperative pain or pain associated with clinical conditions in neonates...
October 7, 2016: Cochrane Database of Systematic Reviews
Rachel B Rapkin, Sharon L Achilles, E Bimla Schwarz, Leslie Meyn, Miriam Cremer, Christy M Boraas, Beatrice A Chen
OBJECTIVE: To evaluate self-administration of vaginal lidocaine gel to decrease pain with intrauterine device (IUD) insertion in nulliparous women. METHODS: In this randomized, double-blind, placebo-controlled trial, women self-administered 2% lidocaine or placebo vaginal gel 5 minutes before IUD insertion. The primary outcome was change in pain from baseline to IUD insertion on a 100-mm visual analog scale. We also assessed pain after speculum insertion, tenaculum placement, uterine sounding, and 5 minutes after IUD insertion...
September 2016: Obstetrics and Gynecology
Roxana Kargar, Afsaneh Aghazadeh-Nainie, Hamid Reza Khoddami-Vishteh
OBJECTIVE: To compare the efficacy of EMLA cream and lidocaine injection to reduce pain during episiotomy repair. MATERIALS AND METHODS: A total of 46 primiparous women with normal pregnancy who referred for normal vaginal delivery and needed episiotomy repair were selected and randomly divided into two groups. For EMLA group, one hour before the estimated time of delivery, 5g of EMLA cream was applied to perinealmediolateral incision, and after the delivery of the fetus and placenta, again 5g of EMLA cream was applied to healthy skin around the episiotomy for repair...
March 2016: Journal of Family & Reproductive Health
A Guillaume, E Schuller-Dufour, V Faitot, O Pirrello, C Rongières, J Ohl, I Nisand, K Bettahar
A recent adverse effect of a paracervical block (cardiac arrest) occurred during an oocyte retrieval (OR), forcing us to reconsider our pain management during OR. Since then, we decided to use intravaginal lidocaine gel as analgesia during OR. OBJECTIVES: To evaluate the pain during OR after intravaginal lidocaine gel analgesia and to evaluate the motivations of women choosing this technique. METHODS: A monocentric observational study was performed on 200 patients...
October 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Bridget Martell, Harvey Kushner, Elaine Richardson, Amy Mize, Philip Mayer
Lidocaine vaginal bioadhesive gel is being developed as a local anesthetic for use in minimally invasive outpatient gynecological procedures and was investigated in single-dose and multiple-dose studies in healthy young adult women. Lidocaine doses of 2.5%, 5%, and 10% (w/w) were administered, and parent drug and metabolites monoethylglycinexylidide and glycinexylidide were measured in plasma. Lidocaine was absorbed through vaginal tissue and into the systemic circulation in a dose-proportional manner, and there was little systemic accumulation...
January 2017: Clinical Pharmacology in Drug Development
Brian J Linder, John B Gebhart, John A Occhino
INTRODUCTION: We present a video describing the technical considerations for performing a total colpocleisis in the management of symptomatic post-hysterectomy pelvic organ prolapse. METHODS: A 76-year old female presented with pelvic pressure and the presence of a palpable vaginal bulge. She had significant bother and had previously failed use of a pessary. She wasnot sexually active, with no plans for future sexual activity. Her medical history was significant for coronary artery disease with prior myocardial infarction...
November 2016: International Urogynecology Journal
Ilan E Timor-Tritsch, Ana Monteagudo, Terri-Ann Bennett, Christine Foley, Joanne Ramos, Andrea Kaelin Agten
BACKGROUND: Cesarean scar pregnancy and cervical pregnancy are unrelated forms of pathological pregnancies carrying significant diagnostic and treatment challenges, with a wide range of treatment effectiveness and complication rates ranging from 10% to 62%. At times, life-saving hysterectomy and uterine artery embolization are required to treat complications. Based on our previous success with using a single-balloon catheter for the treatment of cesarean scar pregnancy after local injection of methotrexate, we evaluated the use of a double-balloon catheter to terminate the pregnancy while preventing bleeding without any additive treatment...
September 2016: American Journal of Obstetrics and Gynecology
Usama M Fouda, Noha M Salah Eldin, Khaled A Elsetohy, Hoda A Tolba, Mona M Shaban, Sherin M Sobh
OBJECTIVE: To determine the effectiveness of diclofenac potassium combined with 2% lidocaine gel in reducing the pain of intrauterine device (IUD) insertion. STUDY DESIGN: We randomized 90 parous women requesting copper T380A IUD insertion in a 1:1 ratio to active or placebo treatment. Active treatment included administration of two 50-mg diclofenac potassium tablets 1h before IUD insertion, application of 3mL of 2% lidocaine gel on the anterior cervical lip 3min before IUD insertion and placement of a cotton swab soaked in 2% lidocaine gel in the cervical canal 3min before IUD insertion...
June 2016: Contraception
Marrissa Martyn-St James, Katy Cooper, Kate Ren, Eva Kaltenthaler, Kath Dickinson, Anna Cantrell, Kevan Wylie, Leila Frodsham, Catherine Hood
Eutectic Mixture of Local Anaesthetics (EMLA) is recommended for use off-label as a treatment for premature ejaculation (PE). Other topical anaesthetics are available, some of which have been evaluated against oral treatments. The purpose of this systematic review was to evaluate the evidence from randomised controlled trials (RCTs) for topical anaesthetics in the management of PE. Bibliographic databases including MEDLINE were searched to August 2014. The primary outcome was intra-vaginal ejaculatory latency time (IELT)...
April 2016: Sexual Health
Laureen M Lopez, Alissa Bernholc, Yanwu Zeng, Rebecca H Allen, Deborah Bartz, Paul A O'Brien, David Hubacher
BACKGROUND: Fear of pain during insertion of intrauterine contraception (IUC) is a barrier to use of this method. IUC includes copper-containing intrauterine devices and levonorgestrel-releasing intrauterine systems. Interventions for pain control during IUC insertion include non-steroidal anti-inflammatory drugs (NSAIDs), local cervical anesthetics, and cervical ripening agents such as misoprostol. OBJECTIVES: To review randomized controlled trials (RCTs) of interventions for reducing IUC insertion-related pain SEARCH METHODS: We searched for trials in CENTRAL, MEDLINE, EMBASE, POPLINE, ClinicalTrials...
2015: Cochrane Database of Systematic Reviews
Martha F Goetsch, Jeong Y Lim, Aaron B Caughey
PURPOSE: Dyspareunia is common in breast cancer survivors because of low estrogen. This study explored whether dyspareunia is introital pain, preventable with analgesic liquid. PATIENTS AND METHODS: In a randomized, controlled, double-blind trial, estrogen-deficient breast cancer survivors with severe penetrative dyspareunia applied either saline or 4% aqueous lidocaine to the vulvar vestibule for 3 minutes before vaginal penetration. After a 1-month blinded trial of patient-assessed twice-per-week tampon insertion or intercourse, all patients received lidocaine for 2 months in an open-label trial...
October 20, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Sasha Mazzarello, Brian Hutton, Mohammed F K Ibrahim, Carmel Jacobs, Risa Shorr, Stephanie Smith, Terry Ng, Mark Clemons
Symptoms of urogenital atrophy are common in breast cancer survivors. Its optimal management is currently unknown. A systematic review of randomized controlled trials (RCTs) evaluating treatments for urogenital atrophy in breast cancer patients was performed. EMBASE, Ovid Medline and the Cochrane Library were searched from 1946 to November 2014. Outcomes included improvements in both vaginal symptoms (e.g., dryness, pain, dyspareunia and itching) and vaginal hormone response measured by validated scales [e...
July 2015: Breast Cancer Research and Treatment
Kelly Griffin, Rohan Brent, Beverley Vollenhoven, Amy E Swanson
BACKGROUND: Life-threatening injury from battery ingestion has mandated changes in the manufacture of battery-operated devices. Whilst esophageal burns are commonly publicized, there is scarce literature on vaginal burns and their potential morbidity. CASE: An 8-year-old girl presented with self-report of a "fluffy toy" per vagina. Under general anesthesia, her vagina was examined and the mucosa appeared coated in a "blue fur." It was soon identified as corrosive damage from an alkaline button battery...
August 2015: Journal of Pediatric and Adolescent Gynecology
Murat Öz, Elmas Korkmaz, Nilufer Cetinkaya, Sevda Baş, Bülent Özdal, Mehmet Mutlu Meydanl, Tayfun Güngör
OBJECTIVE: To compare the effectiveness of topical lidocaine spray compared to a placebo for relieving pain during colposcopic cervical biopsies and endocervical curettage. METHODS: This randomized, placebo-controlled, double-blind study included patients with abnormal cervical cytologic results requiring colposcopy and directed cervical punch biopsy with or without endocervical curettage (ECC). The patients were randomly assigned to either the 10% lidocaine spray or the placebo group...
July 2015: Journal of Lower Genital Tract Disease
Lara Hathout, Jamie Cohn, Laszlo Voros, Sae Hee Kim, Todd Heaton, Suzanne L Wolden
PURPOSE: To report the technical aspects of customized high-dose-rate brachytherapy for vaginal rhabdomyosarcoma using MRI- and CT-based planning in a 20-month-old girl. METHODS AND MATERIALS: An impression of the vaginal cavity at the resection site was taken after adequate lubrication of the vagina with lidocaine jelly. The impression was processed in the dental laboratory to obtain an MRI-compatible device with three imbedded catheters 0.4 mm apart, assuring tumor coverage...
January 2015: Brachytherapy
T V B Castro, S A Franceschini, O Poli-Neto, R A Ferriani, M F Silva de Sá, C S Vieira
STUDY QUESTION: Is the pain associated with levonorgestrel-releasing intrauterine system (LNG-IUS) insertion reduced by intracervical anesthesia in women without previous vaginal birth? SUMMARY ANSWER: Intracervical anesthesia was not associated with reduced pain in women without previous vaginal birth. WHAT IS KNOWN ALREADY: The pain associated with the insertion of intrauterine contraceptives (IUCs) is a limiting factor for the use of these contraceptives by some women...
November 2014: Human Reproduction
Martha F Goetsch, Jeong Y Lim, Aaron B Caughey
OBJECTIVE: To locate sites of genital tenderness in breast cancer survivors not using estrogen who experience dyspareunia and to test the hypothesis that tenderness is limited to the vulvar vestibule rather than the vagina and is reversed by topical anesthetic. METHODS: Postmenopausal survivors of breast cancer with moderate and severe dyspareunia were recruited for an examination including randomization to a double-blind intervention using topical aqueous 4% lidocaine or normal saline for 3 minutes to the areas found to be tender...
June 2014: Obstetrics and Gynecology
Martha F Goetsch, Jeong Y Lim, Aaron B Caughey
INTRODUCTION: Research has focused on vaginal atrophy as the cause of dyspareunia in postmenopausal women. This study explored whether penetrative pain was prevented after hypoestrogenic patients applied analgesic liquid to the vulvar vestibule. METHODS: In a randomized controlled, double-blind trial, estrogen-deficient breast cancer survivors with severe penetrative dyspareunia applied either saline or 4% aqueous lidocaine to the vulvar vestibule for 3 minutes before vaginal penetration...
May 2014: Obstetrics and Gynecology
Rachel B Rapkin, Sharon L Achilles, Christy Boraas, Miriam Cremer, E Bimla Schwarz, Beatrice A Chen
INTRODUCTION: Despite their high efficacy, intrauterine device (IUD) use is limited among nulliparous women, often as a result of fear of pain. Prior studies evaluating pain management during insertion usually include multiparous women and show no benefit. This study evaluates self-administered lidocaine gel before IUD insertion in nulliparous women. METHODS: Nulliparous women seeking IUDs were randomly assigned to self-administer 1% lidocaine or placebo gel 5 minutes before IUD insertion...
May 2014: Obstetrics and Gynecology
Ravinder K Mittal, Valmik Bhargava, Geoff Sheean, Melissa Ledgerwood, Shantanu Sinha
The external anal sphincter (EAS) may be injured in 25-35% of women during the first and subsequent vaginal childbirths and is likely the most common cause of anal incontinence. Since its first description almost 300 years ago, the EAS was believed to be a circular or a "donut-shaped" structure. Using three-dimensional transperineal ultrasound imaging, MRI, diffusion tensor imaging, and muscle fiber tracking, we delineated various components of the EAS and their muscle fiber directions. These novel imaging techniques suggest "purse-string" morphology, with "EAS muscles" crossing contralaterally in the perineal body to the contralateral transverse perineal (TP) and bulbospongiosus (BS) muscles, thus attaching the EAS to the pubic rami...
March 2014: American Journal of Physiology. Gastrointestinal and Liver Physiology
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