Oral Etoricoxib for Pain Relief during Fractional Curettage: A Ramdomized Controlled Trial
Wilaiporn Phittayawechwiwat MD*, Chalermsri Thanantaseth MD*, Nathpong Israngura Na Ayudhya MD*, Pratak O-Prasertsawat MD*, Jitlada Kongprasert BSc**
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University ** Department of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Objective : To compare the efficacy of oral etoricoxib and placebo combined with paracervical block for pain
relief during fractional curettage
Materials and Methods : 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
