title: Analgesia for colposcopy: double-masked, randomized comparison of ibuprofen and benzocaine gel.
abstract: OBJECTIVE
  To evaluate pain relief effectiveness of oral ibuprofen and topical benzocaine gel during colposcopy.
  
  
  METHODS
  In a double-masked, randomized controlled trial, women who attended a family medicine colposcopy clinic received one of four treatments, 800 mg of oral ibuprofen, 20% topical benzocaine, both, or placebos. Using visual analog scales, women recorded their pain after speculum placement, endocervical curettage (ECC), and cervical biopsy. Participants were 18-55 years old, spoke English, and were not taking other pain or psychotropic medications. Demographic and historical information was collected from each participant.
  
  
  RESULTS
  Ninety-nine subjects participated. Twenty-five received oral ibuprofen and topical benzocaine (median pain scores on a 10-point scale for speculum placement, ECC, and biopsy were 0.75, 3.00, and 3.38, respectively), 24 received oral placebo and topical benzocaine (1.00, 3.75, and 2.63), 24 received oral ibuprofen and topical placebo (0.63, 3.75, and 2.25), and 26 received oral and topical placebos (0.75, 3.50, and 3.00). There were no statistically significant differences in patient visual analogue pain scale scores across the four groups (statistical power, ECC = 0.74, cervical biopsy = 0.62). Younger women and women who had pain with speculum placement were more likely to have increased pain during ECC. Increased pain during biopsy was associated with history of severe dysmenorrhea but no other demographic or historical factors. Women overall reported ECC and biopsy to be mildly painful, with median scores of 3.5 for ECC and 2.75 for biopsy on a 10-point scale. The range in pain scores was large, with some women reporting severe pain (for ECC minimum = 0.25, maximum = 10.0; biopsy: minimum = 0.0, maximum = 9.0).
  
  
  CONCLUSIONS
  Colposcopy is perceived as somewhat painful, but oral ibuprofen and topical benzocaine gel, alone or together, provided no advantage over placebo in decreasing colposcopy pain.
authors.affiliation: Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington 98105, USA. llchurch@u.washington.edu
authors.forename: L
authors.initials: L
authors.lastname: Church
authors.forename: L
authors.initials: L
authors.lastname: Oliver
authors.forename: S
authors.initials: S
authors.lastname: Dobie
authors.forename: D
authors.initials: D
authors.lastname: Madigan
authors.forename: A
authors.initials: A
authors.lastname: Ellsworth
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001566:Benzocaine / Q000008:administration & dosage; D003127:Colposcopy; D004311:Double-Blind Method; D005260:Female; D005782:Gels; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage; D010147:Pain Measurement
chemical_list: D005782:Gels; D001566:Benzocaine; D007052:Ibuprofen