Nitrous Oxide for Pain Management During In-office Transcervical Sterilization

The standard transcervical sterilization procedure is not being evaluated in this study, and will be performed in the same manner in the two study arms. The procedure includes a standardized paracervical block with 1% lidocaine. A 5mm operative hysteroscope is passed through the cervix and into the uterine cavity using normal saline for uterine distention. Each tubal ostium is identified, followed by deployment of the device into each fallopian tube. A confirmatory test, hysterosalpingogram, is required at 90 days post procedure to demonstrate successful sterilization.

one 5/325mg hydrocodone/acetaminophen (Vicodin) tablet and one 1mg Lorazepam tablet given to patients randomized to the active comparator arm at least 30 minutes before the procedure

30mg of intramuscular ketorolac given to all patients at least 30 minutes before the procedure

Two placebo bills given to patients randomized to the experimental arm at least 30 minutes prior to the procedure

Oxygen at 5L/min given to patients randomized to the active comparator arm

Nitrous oxide with a maximum titration of up to 70% given to patients randomized to the experimental arm