The use of topical anesthesia in diagnostic hysteroscopy and endometrial biopsy.
OBJECTIVE
To determine whether the pain and discomfort of routine hysteroscopy with endometrial biopsy to diagnose infertility and endometrial pathology can be minimized by topical application of mepivacaine.


METHODS
Prospective, randomized, double-blind study.


METHODS
The Department of Obstetrics and Gynecology at a teaching hospital in Rome, Italy.


METHODS
Eighteen women undergoing diagnostic hysteroscopy.


METHODS
Hysteroscopy and endometrial biopsy were performed after transcervical injection of 5 ml 2% mepivacaine or 5 ml saline solution into the uterine cavity.


RESULTS
Difficulty introducing the hysteroscope was rated by the operator on a scale of 1 to 3. An observer scored visible signs of each woman's distress using a three-point scale. The patients reported their pain 15, 30, 60, 120 minutes after the procedure on a visual analog scale. Mepivacaine was more effective than placebo according to all measurements.


CONCLUSIONS
Topical mepivacaine reduced the pain experienced during and after hysteroscopy and endometrial biopsy.
Zupi
E
E
12 Viale Parioli, 00197 Rome, Italy.
Luciano
A A
AA
Marconi
D
D
Valli
E
E
Patrizi
G
G
Romanini
C
C
D000328:Adult; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000627:therapeutic use; D001707:Biopsy, Needle; D004311:Double-Blind Method; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007247:Infertility, Female / Q000175:diagnosis* / Q000473:pathology; D015552:Injections, Intralesional; D008619:Mepivacaine / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D014592:Uterine Hemorrhage / Q000175:diagnosis* / Q000473:pathology
D000779:Anesthetics, Local; D008619:Mepivacaine