Intrauterine lidocaine plus buccal misoprostol in the endometrial biopsy.
OBJECTIVE
To evaluate the efficacy of intrauterine lidocaine plus buccal misoprostol in reducing the discomfort caused by endometrial biopsy with a suction curette.


METHODS
In this double-blind, randomized, placebo-controlled trial 126 women undergoing endometrial biopsy were administered a 200-microg tablet of misoprostol buccally, followed by a 5-mL uterine instillation of either of 2% lidocaine or a saline solution. The main outcome measures were the intensity of pain during, immediately following, and 20 min following the biopsy, as assessed on a 10-cm visual analog scale. Statistical analysis was performed using the Friedman test with the Bonferroni correction, the t test, and the chi(2) test.


RESULTS
There were no statistically significant differences between the study and control groups in mean age, parity, or relevant medical history. A statistically significant difference in pain scores was noted in premenopausal women during the procedure (lidocaine, 4.93+/-1.67; placebo, 6.17+/-1.26; P<0.001) as well as immediately later (lidocaine, 4.12+/-1.14 vs. placebo, 5.42+/-1.08; P<0.001) and 20 min later (lidocaine, 3.60+/-1.10; placebo, 4.22+/-1.46; P<0.001). No significant differences in pain scores were observed in postmenopausal women for any of the 3 time points (6.72+/-2.01, 5.18+/-1.22, and 4.56+/-0.80, respectively; P>0.05). The number needed to treat was 2.6 (95% confidence interval, 1.9-4.8).


CONCLUSIONS
Intrauterine lidocaine plus buccal misoprostol appears to be effective in decreasing pain in premenopausal women undergoing endometrial biopsy with a suction curette.
Güney
M
M
Department of Obstetrics and Gynecology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey. mguney@med.sdu.edu.tr
Oral
B
B
Mungan
T
T
D000282:Administration, Intravaginal; D000765:Anesthesia, Conduction / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000379:methods; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001707:Biopsy, Needle / Q000009:adverse effects*; D004311:Double-Blind Method; D004717:Endometrium / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D016595:Misoprostol / Q000008:administration & dosage*; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D014619:Vacuum Curettage
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D016595:Misoprostol; D008012:Lidocaine