The Effects Of Lidocaine Cream Combined With Tramadol Hydrochloride On Reduction Of Vulva Pain During Focused Ultrasound Treatment

Objective: To evaluation the efficacy and safety of lidocaine cream combined with tramadol hydrochloride topical administration on reduction of vulva pain during focused ultrasound(FUS)treatment.Methods: A total of 120 eligible patients with NNEDV were treated with focused ultrasound.These patients were randomly divided into lidocaine cream combined with tramadol hydrochloride group and lidocaine injection group.In the lidocaine cream combined with tramadol hydrochloride group,10 g lidocaine cream was applied to vulva for over1 h,and followed by 2ml(100mg)tramadol hydrochloride were given intravenously before FUS treatment.In the lidocaine injection group,2%lidocaine 15 ml and normal saline 15 ml were applied by subcutaneous injection before FUS treatment.Subgroup analysis was conducted based on the different time of lidocaine cream was applied.Pain was recorded using a 10 cm visual analog scale during treatment.The patients’ self-reported pain,perioperative comfort with anesthesia and side effects of anesthesia were recorded.The complications were followed up for one day after treatment and effectiveness of FUS were followed up for six months.Results: There were no significant differences between the two groups with respect to pain score during treatment(P > 0.05).Also,no significant difference was found between the two groups concerning analgesic effect and effectiveness of FUS treatment(P > 0.05).Considering side effects of anesthesia,the complications were detected in vulva skin were erythema in the lidocaine cream combined with tramadol hydrochloride group and edema in the lidocaine injection group.It should be noted that no serious anesthetic adverse reactions occurred in the two groups.The lidocaine cream combined with tramadol hydrochloride group have a higher level of patient perioperative comfort with anesthesia than the lidocaine injection group(P<0.05).Conclusion: Lidocaine cream combined with tramadol hydrochloride resulted in a higher level of patient perioperative comfort with anesthesia and no substantial difference in pain during treatment when compared with lidocaine injection.It is concluded that lidocaine cream combined with tramadol hydrochloride is an effective alternative to lidocaine injection during the treatment of NNEDV by focused ultrasound.