Our review revealed a great heterogeneity in definition , format , and values of what is considered a clinical ly relevant difference in pain in RCTs of analgesics , and st and ardizations are advisable
OBJECTIVE To describe the  pain decrease considered as clinical ly relevant when design ing a trial and reporting its results .
Effectiveness of Intrauterine Anesthesia for Pain Relief During Fractional Curettage
Objective : To study the effectiveness of intrauterine anesthesia for pain relief during fractional curettage . Methods : A double-blinded , r and omized , placebo-controlled trial was conducted in 66 patients with abnormal uterine bleeding undergoing fractional curettage under paracervical block , using 10-mL 1 % lidocaine plus intrauterine 5-mL 2 % lidocaine ( n = 33 ) or saline ( n = 33 ) . The primary outcome was the maximum pain score measured with a 10-cm visual analog scale . Other outcomes measured included pain profile , number of patients with pain score more than 4 , each patient 's global satisfaction index , adverse events , and serum lidocaine profile . Results : The 2 groups were comparable in age , body mass index , education , socioeconomic status , menopausal status , and parity . Compared with the saline group , the lidocaine group had a significantly lower median value for the maximum pain score ( 2.3 versus 4.7 , P = .022 ) and fewer patients with a pain score more than 4 ( 33.3 % versus 60.6 % , P = .026 ) . The pain scores were lower at the endocervical curettage and the uterine curettage steps . There was no difference between the 2 groups in other outcomes . The number needed to treat to prevent a case with a pain score more than 4 was 3.7 ( 95 % confidence interval 2.4–38.5 ) . Conclusion : The addition of intrauterine anesthesia to paracervical block can further reduce pain during fractional curettage without increasing adverse effects . Level of Evidence :
Our review revealed a great heterogeneity in definition , format , and values of what is considered a clinical ly relevant difference in pain in RCTs of analgesics , and st and ardizations are advisable
OBJECTIVE To describe the  pain decrease considered as clinical ly relevant when design ing a trial and reporting its results .