The highest observed concentration was 531 nM, which corresponds to 0.124 μg/ml or 124 ng/ml, and was seen after 30 min (Table 2; Fig. 1). Table 2 Serum concentration of lignocaine Time point

(min) Concentration of lignocaine in ng/ml Mean (SD) Interquartile range Median Min–Max 0 0 (0) 0–0   0–0 5 16.1 (23.4) 1.1–20.5 7.3 0–90.2 15 38.0 (25.1) 18.3–57.9 30.8 7.3–80.4 30 49.7 (24.8) 36.6–59.3 43.3 18.7–124 Fig. 1 Serum concentration of lignocaine Of 16 patients, 14 had the highest level in the last sample, i.e. after 30 min. One had the highest level after 5 min and one after 15 min. T max and C max could not be calculated, since the highest values were observed in the 30-min samples. Lignocaine LY3023414 nmr was not found in any of the serum samples after pertubation with placebo (nine patients). In total, 166 gynaecological examinations were carried out during the study, 42 of which were screening selleck visits and 124 were treatment visits. There were no adverse events related to the treatment with lignocaine. Blood pressure and heart frequency recorded before pertubation were normal and did not change in either the lignocaine or the

placebo group following treatment. Mild discomfort was experienced during the pertubation process at 11 of 124 treatments. 4 Discussion This study shows that pertubation with lignocaine is safe. The serum levels of lignocaine following pertubation of 10 mg lignocaine hydrochloride are detectable but low. Our highest level was 0.124 μg/ml, which is about 80 times below the toxic levels of 10 μg/ml. The serum concentrations detected are consistent with other studies and correspond to the low dose pertubated [11]. Study data support the theory that lignocaine pertubated through the fallopian tubes reaches the peritoneal cavity and diffuses through the peritoneum into the blood circulation. The

levels rose during the follow-up time, and the highest values were observed after 30 min. The major part of the pertubated fluid is thought to reach the peritoneal cavity. Some lignocaine might also be absorbed by the endometrium or by the lining of the fallopian Palmatine tubes during the pertubation process of approximately 5 min. Lignocaine is a potent drug and a high dosage of lignocaine in the central circulation would be a potential risk. During the pertubation treatment, the solution is infused into the uterine cavity under ultrasound supervision and could possibly be accidently placed directly into a blood vessel. However, if the solution had accidently been infused into a vessel, the serum concentration would have risen much faster. The highest level in one patient was reached after 5 min, but the level was very low (0.090 μg/ml).