Objective: To compare the efficacy of oral etoricoxib and placebo combined with paracervical block for pain relief during fractional curettage
Material and Method: 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.
Results: 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.
Conclusion: 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.

Keywords: Verbal rating scale, Etoricoxib, Fractional curettage, Paracervical block