| Title: |
Multimodal Pain Management Strategies for in Office Cervical Biopsy in Women with Recurrent Cervicitis |
| Authors: |
Farzana Muneer; Humera Javed; Andleeb Khalid; Asif Ali |
| Source: |
Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University; Vol. 20 No. 4 (2024): October-December; 986-991 ; 1815-2287 |
| Publisher Information: |
Shaheed Zulfiqar Ali Bhutto Medical University |
| Publication Year: |
2024 |
| Collection: |
Annals of PIMS (Pakistan Institute of Medical Sciences) |
| Description: |
Objective: To compare the effectiveness of multimodal analgesia with single-modality and standard care in reducing pain and anxiety and improving patient satisfaction among women undergoing colposcopy-directed cervical biopsy. Methodology: A randomized controlled trial was conducted at the Department of Obstetrics and Gynecology, Chitral Scouts Hospital, from October 2023 to July 2024. A total of 370 women aged 18–50 years with recurrent cervicitis were randomized into three groups: Control (standard care, n = 123), Single-modality (local infiltration with 2% lidocaine, n = 123), and Multimodal (oral etoricoxib 120 mg one hour before procedure + local lidocaine infiltration + non-pharmacological support including forced cough and verbal reassurance, n = 124). Pain intensity was assessed using a Visual Analogue Scale (VAS, 0–10) before, during, and 15 minutes after biopsy. Anxiety was measured using the State-Trait Anxiety Inventory (STAI), and satisfaction was rated on a 5-point Likert scale. Data were analyzed using SPSS version 26.0, with ANOVA and Chi-square tests; p < 0.05 was considered significant. Results: Baseline characteristics were comparable among groups (p > 0.05). Intra-procedural pain scores were significantly lower in the Multimodal group (2.3 ± 0.9) than in Single-modality (4.5 ± 1.2) and Control groups (6.8 ± 1.4) (p < 0.001). Post-procedure pain showed a similar pattern (1.5 ± 0.7 vs. 2.9 ± 0.8 and 4.1 ± 1.0, p < 0.001). The Multimodal group also reported lower anxiety scores (34.2 ± 6.5, p = 0.004), higher satisfaction (91.9%, p < 0.001), and greater willingness for repeat biopsy (87.9%, p < 0.001). Mild adverse effects were comparable across groups (p = 0.65). Conclusion: Multimodal analgesia significantly reduced pain and anxiety while improving satisfaction without increasing side effects. It is a safe and effective approach for outpatient cervical biopsies in women with recurrent cervicitis. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://apims.net/apims/article/view/798/1101; https://apims.net/apims/article/view/798 |
| Availability: |
https://apims.net/apims/article/view/798 |
| Rights: |
Copyright (c) 2024 Hira Nadeem, Muhammad Umar, Muhammad Usman Nadeem, Muhmmad Bilal Mustafa ; https://creativecommons.org/licenses/by-nc/4.0 |
| Accession Number: |
edsbas.DB0A642F |
| Database: |
BASE |