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Objective: To investigate the effect of 2% lidocaine gel for pain relief during endometrial sampling procedures compared with placebo.
Materials and Methods: This double-blinded randomized, prospective, placebo-controlled study was performed at an out-patient gynecology clinic, tertiary teaching hospital, Bangkok, Thailand from September 2018 to April 2019. Sixty women who were indicated for endometrial tissue sampling were randomly assigned to either lidocaine group, which received 2% lidocaine gel 1 milliliter applied at cervical os and 2 milliliters pushed into cervical canal 3 minutes before the procedure, or placebo group which received placebo gel administered in the same manner. Pain scores, using 10 centimeter-visual analog scale, were assessed at baseline, when inserting the speculum, during Wallach Endocell® insertion, during endometrial aspiration, immediately after aspiration, and 10 minutes after procedure. Adverse symptoms and signs were also observed.
Results: Mean pain score during endometrial aspiration was significantly lower in the lidocaine group (n=29) compared with placebo (n=29) (2.92 + 2.40 and 4.47 + 2.06, respectively; p-value = 0.011). Mean pain score at baseline, during Wallach Endocell® insertion, immediately after aspiration, and 10 minutes after procedure were not statistically significantly different between groups (1.52 ± 2.25, 3.13 ± 2.81, 1.89 ± 2.23, and 0.62 ± 1.32 in the lidocaine group, and 1.69 ± 2.07, 4.20± 2.35, 2.95± 2.33, and 0.93 ± 1.36 in the placebo group, respectively (p-value > 0.05)). There were no adverse symptoms and signs observed.
Conclusion: The 2% lidocaine gel applied at the cervical surface and internal cervical canal was effective for pain relief during endometrial sampling.
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