Lidocaine spray and outpatient hysteroscopy: randomized placebo-controlled trial.
OBJECTIVE
To assess the efficacy of lidocaine spray during outpatient hysteroscopy for reducing procedure-related pain and to identify risk factors for discomfort.


METHODS
One hundred twenty-one women were assigned randomly to have application of lidocaine spray or placebo to the uterine cervix during outpatient hysteroscopy. The main outcome measure was pain during hysteroscopy, assessed on a visual analog scale.


RESULTS
There was no statistically significant difference between study and control groups in mean age, rate of nulliparity, postmenopausal state, need for cervical dilation, or percentage of women who used hormone replacement therapy. Indications for diagnostic hysteroscopy were similar between groups. Women in the lidocaine group had statistically significantly less pain during the procedure than women in the placebo group (2.2 +/- 1.9 and 3.7 +/- 2.5, respectively; P <.001). Women with abnormal uterine findings (submucous myoma, endometrial polyps, or intrauterine adhesions) had significantly higher pain scores than women with normal cavities (2.2 +/- 1.9 and 3.2 +/- 2.4, respectively; P <.002). Aerosol anesthesia and normal uterine findings were independently associated with less pain. No procedure had to be abandoned because of excessive pain or complications, and no women required hospitalization.


CONCLUSIONS
Women treated with lidocaine spray had significantly less pain. Uterine cavity abnormality might be associated with a higher degree of pain during hysteroscopy.
Soriano
D
D
Service de Gynécologie, Hôpital Hôtel-Dieu de Paris, Université Paris, Paris, France.
Ajaj
S
S
Chuong
T
T
Deval
B
B
Fauconnier
A
A
Daraï
E
E
D000336:Aerosols; D000556:Ambulatory Surgical Procedures; D000779:Anesthetics, Local / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000473:pathology / Q000601:surgery*
D000336:Aerosols; D000779:Anesthetics, Local; D008012:Lidocaine