Lidocaine Spray for Pain Control during Office-based Endometrial Biopsy: A randomized placebo-controlled trial

Abstract

Objectives: To evaluate effectiveness of 10% lidocaine spray for pain relief during office-based endometrial biopsy Materials and Methods: Fifty women who indicated for endometrial tissue sampling by Wallach endocell® participated in this randomized, double blinded, placebo-controlled study. The procedures were performed at out-patient gynecology clinic, Department of Obstetrics and Gynecology, Vajira hospital, Bangkok, Thailand, from July 2016 to April 2017. Participants were simple randomly assigned to either lidocaine group which they will receive 5 puff of 10% lidocaine solution spray (50 mg), four puff to cervical surface and one puff towards internal os, or placebo group which they will receive 5 ml placebo solution spray administered in the same manner. Pain score was measured intraoperation, immediate after, 15 minutes and 30 minutes post-operation, using a 10 cm-visual analog scale (VAS-10). Results: Lidocaine spray application during office-based endometrial biopsy significantly lowered the overall pain score compared with placebo (coefficient -3.27, p < 0.001, multilevel linear regression). Mean pain score during procedure was 3.56 ± 1.50 in the lidocaine group (n=25) and 7.28 ± 1.02 in the placebo group (n=25) (p < 0.001). The mean pain score immediate after, at 15 and 30 minutes after the procedure was 3.04 ± 1.31, 0.80 ± 1.41 and 0.08 ± 0.40 in the lidocaine spray group respectively and 7.08 ± 1.19, 3.92 ± 1.47 and 1.92 ± 1.41 in the placebo group respectively (p < 0.001).Conclusion: 10% lidocaine spray applied at cervical surface and internal cervical os was effective for pain relief during and immediate after office-based endometrial Biopsy.

Keywords

• endometrial biopsy
• lidocaine spray
• pain control
• analgesia