Analgesic Effect of Lidocaine Spray during Endometrial Biopsy: A randomized controlled trial

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Maneenuch Sripha
Chuenkamon Charakorn
Navamol Lekskul
Arb-aroon Lertkhachonsuk

Abstract

Objective: To investigate the effect of lidocaine spray applied on the cervical surface in pain reduction of patients undergoing endometrial biopsy using the Endosampler instrument.


Materials and methods: A double blinded randomized controlled study was conducted in 100 women undergoing endometrial biopsy. Patients were randomly assigned to receive either lidocaine spray or placebo. Visual analog scale (VAS) was used to assess patients’ pain at three points of the procedure (speculum insertion, cannula insertion and after speculum removal). The satisfaction of the procedure was evaluated by patients and doctors using five point Likert scale.


Results: Endometrial biopsy was successfully performed in 100 patients. The median VAS pain score during cannula insertion in the Lidocaine group was 5.0 which was lower than 5.5 in the placebo group without statistical significance.


Conclusion: Lidocaine spray application on cervix before endometrial biopsy did not significantly reduce pain in patients who underwent this procedure.


Keywords: Endometrial biopsy, Lidocaine spray, Pain score, Randomized controlled trial

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References

1. Committee on Practice Bulletins-Gynecology. Practice bulletin no. 128: diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol. 2012;120(1):197-206.
2. Dijkhuizen FP, Mol BW, Brolmann HA, Heintz AP. The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia: a meta-analysis. Cancer. 2000;89(8):1765-72.
3. Van den Bosch T, Verguts J, Daemen A, Gevaert O, Domali E, Claerhout F, et al. Pain experienced during transvaginal ultrasound, saline contrast sonohysterography, hysteroscopy and office sampling: a comparative study. Ultrasound Obstet Gynecol. 2008;31(3):346-51.
4. Leclair CM, Zia JK, Doom CM, Morgan TK, Edelman AB. Pain experienced using two different methods of endometrial biopsy: a randomized controlled trial. Obstet Gynecol. 2011;117(3):636-41.
5. Khalid AS, Burke C. A randomised trial of Medgyn Endosampler® vs Endocurette® in an outpatient hysteroscopy clinic setting. Gynecol Surg 2014;11:179–18.
6. Vanichtantikul A, Charoenkwan K. Lidocaine spray compared with submucosal injection for reducing pain during loop electrosurgical excision procedure: a randomized controlled trial. Obstet Gynecol. 2013;122(3):553-7.
7. Karasahin E, Alanbay I, Keskin U, Gezginc K, Baser I. Lidocaine 10% spray reduces pain during hysterosalpingography: a randomized controlled trial. J Obstet Gynaecol Res. 2009;35(2):354-8.
8. Aksoy H, Aksoy U, Ozyurt S, Acmaz G, Babayigit M. Lidocaine 10% spray to the cervix reduces pain during intrauterine device insertion: a double-blind randomised controlled trial. J Fam Plann Reprod Health Care. 2016;42(2):83-7.
9 Swieboda P, Filip R, Prystupa A, Drozd M. Assessment of pain: types, mechanism and treatment. Ann Agric Environ Med. 2013; Special Issue 1:2–7.
10 Van der Burght M, Schonemann NK, Laursen JK, Arendt-Nielson L, Bjerring P. Onset and duration of hypoalgesia following application of lidocaine spray on the genital mucosa. Acta Obstet Gynecol Scand. 1994;73:809–11.
11. Aksoy H, Aksoy U, Ozyurt S, Acmaz G, Babayigit MA, Yucel B, et al. Effect of lidocaine spray in pain management during office-based endometrial sampling: A randomised placebo-controlled trial. J Obstet Gynaecol. 2016;36(2):246-50.
12. Crane JM, Craig C, Dawson L, O'Grady T, Bartellas E, Hutchens D. Randomized trial of oral misoprostol before endometrial biopsy. J Obstet Gynaecol Can. 2009;31(11):1054-9.
13. Somchit W, Lertkhachonsuk AA, Vallipakorn SA. Naproxen for pain relief during endometrial biopsy: A Randomized Controlled Trial. J Med Assoc Thai. 2015;98(7):631-5.
14. Cengiz H, Dagdeviren H, Kaya C, Yesil A, Caypinar SS. Comparing the efficacy of intrauterine lidocaine and paracervical block in decreasing the pain associated with endometrial biopsy: a randomised trial. Arch Gynecol Obstet. 2014;289(3):609-14.