The Efficacy of Oral Etoricoxib in Pain Control During Colposcopy-Directed Cervical Biopsy: A Randomized Control Trial

Overview

Journal Asian Pac J Cancer Prev

Specialty Oncology

Date 2023 Aug 29

PMID 37642074

Authors

Sarunya Sivapornpan

Awassada Punyashthira

Nopwaree Chantawong

Pattra Wisarnsirirak

Karicha Mairaing

Yuthadej Thaweekul

Yenrudee Poomtavorn

Junya Pattaraarchachai

Komsun Suwannarurk

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the effectiveness and safety of oral etoricoxib administration before colposcopic procedure for pain relief during and after colposcopy.

Methods: A prospective double-blind, randomized controlled trial was conducted at the colposcopy unit of Thammasat University Hospital, Thailand from August 2022 to January 2023. The participants were women undergoing colposcopy. They were allocated into two groups: etoricoxib group and control group. Thirty minutes prior to colposcopy, the participants received etoricoxib or placebo tablet. A numerical rating scale was used to evaluate pain upon speculum insertion, 3% acetic acid application, directed cervical biopsy (CDB), endocervical curettage (ECC), and 10 minutes and 24 hours after colposcopy.

Result: One hundred and ten women were recruited and were divided equally into study and control groups. The mean age of participants was 42.6 years old. One-fourth of cases (29/110) had cervical intraepithelial neoplasia grade 2 or more histology. Subjects in etoricoxib group had less median pain scores during CDB, ECC, and 10-minute and 24-hour post procedure than the control group with statistical significance. Both groups had comparable side effects.

Conclusion: Administration of oral etoricoxib 30 minutes before colposcopy could reduce pain during and up to 24-hour post colposcopy with minimal side effects.

References

Darweesh F, Samy A, Mousa A, Abdelbar A, Mahmoud M, Abdelhakim A . Role of Oral Tramadol 50 mg in Reducing Pain During Colposcopy-Directed Cervical Biopsy: A Randomized Controlled Trial. J Low Genit Tract Dis. 2020; 24(2):206-210. DOI: 10.1097/LGT.0000000000000522. View

Walker C . Are All Oral COX-2 Selective Inhibitors the Same? A Consideration of Celecoxib, Etoricoxib, and Diclofenac. Int J Rheumatol. 2019; 2018:1302835. PMC: 6304524. DOI: 10.1155/2018/1302835. View

Karaman E, Kolusari A, Alkis I, Cetin O . Comparison of topical lidocaine spray with forced coughing in pain relief during colposcopic biopsy procedure: a randomised trial. J Obstet Gynaecol. 2019; 39(4):534-538. DOI: 10.1080/01443615.2018.1538329. View

Mattar O, Samy A, Shehata M, Ibrahim A, Abdelaziz A, Abdelazeim N . The efficacy of local anesthetics in pain relief during colposcopic-guided biopsy: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol. 2019; 237:189-197. DOI: 10.1016/j.ejogrb.2019.04.047. View

Kiviharju M, Kalliala I, Nieminen P, Dyba T, Riska A, Jakobsson M . Pain Sensation During Colposcopy and Cervical Biopsy, With or Without Local Anesthesia: A Randomized Trial. J Low Genit Tract Dis. 2017; 21(2):102-107. DOI: 10.1097/LGT.0000000000000292. View

Church L, Oliver L, DOBIE S, Madigan D, Ellsworth A . Analgesia for colposcopy: double-masked, randomized comparison of ibuprofen and benzocaine gel. Obstet Gynecol. 2001; 97(1):5-10. DOI: 10.1016/s0029-7844(00)01084-x. View

Moore R, Derry S, Aldington D, Wiffen P . Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. Cochrane Database Syst Rev. 2015; (9):CD008659. PMC: 6485441. DOI: 10.1002/14651858.CD008659.pub3. View

Bogani G, Serati M, Cromi A, DI Naro E, Casarin J, Pinelli C . Local anesthetic versus forced coughing at colposcopic-guided biopsy: a prospective study. Eur J Obstet Gynecol Reprod Biol. 2014; 181:15-9. DOI: 10.1016/j.ejogrb.2014.07.022. View

Wittenborn J, Wagels L, Kupec T, Iborra S, Najjari L, Stickeler E . Anxiety in women referred for colposcopy: a prospective observational study. Arch Gynecol Obstet. 2021; 305(3):625-630. PMC: 8918141. DOI: 10.1007/s00404-021-06337-8. View

10.

Hecken J, Rezniczek G, Tempfer C . Innovative Diagnostic and Therapeutic Interventions in Cervical Dysplasia: A Systematic Review of Controlled Trials. Cancers (Basel). 2022; 14(11). PMC: 9179487. DOI: 10.3390/cancers14112670. View

11.

Wongluecha T, Tantipalakorn C, Charoenkwan K, Srisomboon J . Effect of lidocaine spray during colposcopy-directed cervical biopsy: A randomized controlled trial. J Obstet Gynaecol Res. 2017; 43(9):1460-1464. DOI: 10.1111/jog.13380. View

12.

Pradit L, Tantipalakorn C, Charoenkwan K, Suprasert P, Srisomboon J, Muangmool T . Efficacy of Listening to Music on Pain Reduction during Colposcopy-Directed Cervical Biopsy: A Randomized, Controlled Trial. Medicina (Kaunas). 2022; 58(3). PMC: 8955114. DOI: 10.3390/medicina58030429. View

13.

Perkins R, Guido R, Castle P, Chelmow D, Einstein M, Garcia F . 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J Low Genit Tract Dis. 2020; 24(2):102-131. PMC: 7147428. DOI: 10.1097/LGT.0000000000000525. View