title: Lidocaine does not reduce pain perception during gel instillation sonography or subsequent office hysteroscopy: results of a randomized trial.
abstract: BACKGROUND
  To evaluate if the addition of lidocaine to the gel used for gel infusion sonohysterography (GIS) reduces pain experienced during GIS or subsequent hysteroscopy.
  
  
  METHODS
  A total of 142 consecutive patients were randomized using computer-generated random integers. In 79 patients, GIS was performed with a gel containing lidocaine (Instillagel®) and in 63 patients the gel did not contain lidocaine (Endosgel®). Immediately after GIS, 132 patients (94%) underwent office hysteroscopy. The women were asked to fill in a questionnaire including a 100-mm visual analogue scale (VAS) score after each examination.
  
  
  RESULTS
  The mean age (SD) was 50.8 (12.1) years; 58.5% were premenopausal and 15.6% were nulliparous. The median (interquartile range (IR)) VAS score during GIS for all women was 6 (19.5): 8 (21) for the lidocaine group versus 5 (18.2) for those who received gel without lidocaine. The median (IR) VAS scores during hysteroscopy in the total group, the Instillagel group and the Endosgel group were 15.5 (43.2), 24 (35) and 9 (52), respectively. None of the differences were statistically significant.
  
  
  CONCLUSIONS
  The addition of lidocaine to the gel used either for GIS or prior to office hysteroscopy does not reduce the procedure-related pain.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium. thierry.van.den.bosch @ skynet.be
authors.forename: T
authors.initials: T
authors.lastname: Van den Bosch
authors.forename: D
authors.initials: D
authors.lastname: Van Schoubroeck
authors.forename: A
authors.initials: A
authors.lastname: Daemen
authors.forename: E
authors.initials: E
authors.lastname: Domali
authors.forename: V
authors.initials: V
authors.lastname: Vandenbroucke
authors.forename: B
authors.initials: B
authors.lastname: De Moor
authors.forename: J
authors.initials: J
authors.lastname: Deprest
authors.forename: D
authors.initials: D
authors.lastname: Timmerman
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D005260:Female; D005782:Gels; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D010147:Pain Measurement; D058748:Pain Perception; D011795:Surveys and Questionnaires; D014463:Ultrasonography / Q000379:methods; D014599:Uterus / Q000000981:diagnostic imaging*
chemical_list: D000779:Anesthetics, Local; D005782:Gels; D008012:Lidocaine