title: Forced coughing versus local anesthesia and pain associated with cervical biopsy: a randomized trial.
abstract: OBJECTIVE
  Cervical biopsy often causes discomfort and pain. To compare local anesthesia (1% lidocaine) with forced coughing as pain relief, we quantified the actual pain experienced during cervical punch biopsies.
  
  
  METHODS
  For a prospective trial conducted at the Medical University of Vienna, 68 women undergoing cervical punch biopsies for assessment of abnormal cervical smears were randomized in 2 pain relief treatment groups. Patients' discomfort was assessed immediately after taking the biopsy using at 10-cm visual analog scale.
  
  
  RESULTS
  No statistically significant difference was found between pain scores recorded for the 2 groups (P = .47, 95% confidence interval [CI], -0.4 to 1.3 cm). However, when local anesthesia was applied, the examination was significantly prolonged by a median of 2.11 min (P < .001; 95% CI, 1.6-2.8).
  
  
  CONCLUSIONS
  Forced coughing during cervical biopsies reduces patients' discomfort to the same extent as local anesthesia, but is associated with a significantly reduced examination time.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Bernd C
authors.initials: BC
authors.lastname: Schmid
authors.forename: Sophie
authors.initials: S
authors.lastname: Pils
authors.forename: Georg
authors.initials: G
authors.lastname: Heinze
authors.forename: Lukas
authors.initials: L
authors.lastname: Hefler
authors.forename: Alexander
authors.initials: A
authors.lastname: Reinthaller
authors.forename: Paul
authors.initials: P
authors.lastname: Speiser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods; D001707:Biopsy, Needle / Q000379:methods*; D002584:Cervix Uteri / Q000473:pathology*; D016001:Confidence Intervals; D003371:Cough; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008012:Lidocaine