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

Abstract

To assess whether transcervical intrauterine instillation of local anaesthetic agent reduces pain during diagnostic outpatient hysteroscopy and endometrial biopsy. Prospective, randomised, double blind, placebo-controlled trial. Outpatient hysteroscopy clinic in a university teaching hospital. Ninety women undergoing outpatient diagnostic hysteroscopy with or without endometrial biopsy. Transcervical intrauterine instillation of 5 mL of 2% lignocaine into the uterine cavity before performing the procedure. Evaluation of pain at different stages of the procedure using a visual analogue scale and changes in blood pressure and heart rate. 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. Transcervical instillation of local anaesthesia neither reduced pain nor prevented vaso-vagal reaction during hysteroscopy and endometrial biopsy.