A randomized, placebo‐controlled, double‐blind study of hysteroscopic‐guided pertubal diluted bupivacaine infusion for endometriosis‐associated chronic pelvic pain

Objective To assess the effectiveness of hysteroscopic‐guided pertubal diluted bupivacaine infusion for endometriosis‐associated chronic pelvic pain (CPP). Methods Between June 2010 and July 2013, a randomized, placebo‐controlled, double‐blind study was undertaken at Mansoura University Hospital, Mansoura, Egypt. Patients meeting inclusion criteria (laparoscopically confirmed endometriosis, patent fallopian tubes, ≥ 6 months CPP, pain score on visual analogue scale [VAS] > 5) were randomly assigned using a computer‐generated randomization sequence to receive either office hysteroscopic‐guided pertubal diluted bupivacaine infusion (0.25%) or placebo. Response to treatment was assessed using subjective data for scores on VAS and a monthly verbal rating scale (VRS monthly ) at baseline and at 1, 2, and 3 months of follow‐up. Additionally, women completed a questionnaire to evaluate the overall satisfaction at 3 months. Results Thirty patients were assigned to each group. In the bupivacaine group, VAS and VRS monthly scores were significantly lower at 1, 2, and 3 months than at baseline ( P < 0.05 for all). Additionally, scores were significantly lower in the bupivacaine group than in the placebo group at 1, 2, and 3 months ( P < 0.05 for all). At 3 months, 22 (73%) women in the bupivacaine group expressed satisfaction, compared with 2 (7%) in the placebo group ( P = 0.18). Conclusion Office pertubal hysteroscopic‐guided diluted bupivacaine infusion could be used to manage endometriosis‐associated CPP for at least 3 months. AEARCTR‐0000573