Efficacy of etoricoxib for pain relief during endometrial biopsy; a double blind randomized controlled trial.

OBJECTIVE: To compare the efficacy of oral etoricoxib and placebo for pain relief during endometrial biopsy. MATERIAL AND METHOD: A double-blind, randomized controlled trial that included 80 women who underwent endometrial biopsy was done at Thammasat University Hospital between 1 September 2005 and 30 June 2006. Forty women were randomly allocated to the etoricoxib group (120 mg, tablet) and 40 to the placebo group. The main outcome was the patient's assessment of intensity of pain measured by visual analog scale (VAS) before speculum insertion, during endometrial biopsy, immediately after endometrial biopsy, and 30 minutes after endometrial biopsy. Satisfactory score was also evaluated. RESULTS: Demographic data including age, BMI, previous vaginal deliveries, previous pelvic surgery and history of curettage were not significantly different between the etoricoxib group and the placebo group. Mean pain score in the etoricoxib group was not significantly lower when compared with the placebo group during endometrial biopsy (5.0 +/- 1.7 versus 5.25 +/- 2.2, p = 0.7) and immediately after endometrial biopsy (2.1 +/- 2.2 versus 2.8 +/- 1.7, p = 0.1) but significantly lower at 30 minutes after endometrial biopsy (0.2 +/- 0.5 versus 0.6 +/- 0.8, p = 0.01). Mean satisfactory score was significantly higher in the etoricoxib group (6.9 +/- 1.8 versus 5.1 +/- 2.3, p = 0.001). CONCLUSION: A single oral dose of etoricoxib for reduction of pain during endometrial biopsy had not significantly lower the pain score during the procedure compared with the placebo. However mean satisfactory score in the etoricoxib group was higher with statistically significant difference. Also the authors found no serious adverse effects of this drug.

Reducing cesarean delivery rates: an active management labor program in a setting with limited resources.

OBJECTIVE: To determine the effect of an active management of a labor program on the rate of cesarean section and labor outcomes in low-risk nulliparous pregnancies in a setting with limited resources. MATERIAL AND METHOD: Nine hundred and seventy-five low risk nulliparous pregnant women were randomized to receive either active management of a labor program (n = 325) or conventional management (n = 650). The rate of cesarean section and labor outcomes were compared between the two groups using Chi-square and t-tests. RESULTS: The subjects in the active management program had significantly shortened first stage of labor and total duration of labor compared with the conventional group (538.0 +/- 242.9 min vs 589.4 +/- 263.8 min, p < 0.05, 539.3 +/- 261.4 min vs 610.3 +/- 264.4 min, p < 0.001, respectively). There was no statistical difference found in the rate of cesarean section and other labor outcomes. CONCLUSION: The active management program shortened the first stage and duration of labor in low-risk nulliparous pregnant women.