A randomised double‐blind placebo‐controlled trial of transcervical intrauterine local anaesthesia in outpatient hysteroscopy

• Published in: BJOG : an international journal of obstetrics and gynaecology Vol. 107; no. 5; pp. 610 - 613
• Main Authors: Lau, W. C., Tam, W. H., Lo, W. K., Yuen, P. M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-05-2000
• Subjects: Administration, Topical; Adult; Ambulatory Care - methods; Anesthetics, Local - therapeutic use; Blood Pressure; Chi-Square Distribution; Double-Blind Method; Female; Heart Rate; Humans; Hysteroscopy - adverse effects; Lidocaine - therapeutic use; Middle Aged; Pain Measurement; Prospective Studies; Treatment Outcome
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/j.1471-0528.2000.tb13301.x

Objective
To assess whether transcervical intrauterine instillation of local anaesthetic agent reduces pain during diagnostic outpatient hysteroscopy and endometrial biopsy.
Design
Prospective, randomised, double blind, placebo‐controlled trial.
Setting
Outpatient hysteroscopy clinic in a university teaching hospital.
Population
Ninety women undergoing outpatient diagnostic hysteroscopy with or without endometrial biopsy.
Methods
Transcervical intrauterine instillation of 5 mL of 2% lignocaine into the uterine cavity before performing the procedure.
Main outcome measures
Evaluation of pain at different stages of the procedure using a visual analogue scale and changes in blood pressure and heart rate.
Results
The use of local anaesthetic did not alleviate pain experienced during hysteroscopy and endometrial biopsy. It did not prevent the occurrence of vaso‐vagal reactions; however the incidence of these was low.
Conclusions
Transcervical instillation of local anaesthesia neither reduced pain nor prevented vasovagal reaction during hysteroscopy and endometrial biopsy.