Comparison of the efficacy of intrauterine lidocaine,paracervical block and oral etodolac for decreasing pain in endometrial biopsy [İntrautein lidokain,paraservikal blok ve oral etodolak uygulamalari{dotless}ni{dotless}n endometrial biopside aǧri{dotless}yi{dotless} azaltmadaki etkinliklerinin karşi{dotless}laşti{dotless}ri{dotless}lmasi{dotless}]

Objective: to compare the effectiveness of paracervical block,intrauterine lidocaine and oral etodolac in decreasing the pain caused by pipelle endometrial sampling. a secondary goal of this study was to determine the adverse effects and compare possible effects of these methods on pulse and blood pressure. material and methods: the study was performed between april 2006 and october 2006 in the obstetrics and gynecology department of van yüzüncü yi{dotless}l university research hospital. one-hundred twenty patients were randomized into four groups: 1. group: paracervical block was performed with 3 ml 2% prilocaine solution. 2. group: five ml of 2% lidocaine solution was instilled through the endocervix into the uterine cavity. 3. group: subjects received 400 mg oral etodolac tablet 1-1.5 hour before the procedure. 4. group: no method of anesthesia was used in the control group. endometrial sampling was performed with pipelle. severity of pain during the procedure was scored by the subjects according to the 6-point verbal rating scale (vrs). blood pressure and pulse rate were measured before,during and 30 minutes after the procedure. results: pain scores in intrauterine lidocaine group (2 nd group) were found statistically significantly lower than the other three groups (p<0.05). conclusion: intrauterine lidocaine anesthesia technique decreases pain in endometrial sampling with pipelle more efficiently than paracervical block or oral etodolac. while indication of menorrhagia and endometrial thickness more than 5 mm increased pain scores,intrauterine lidocaine application or paracervical block decreased the scores significantly (p<0.05).