title: Local anesthetic versus forced coughing at colposcopic-guided biopsy: a prospective study.
abstract: OBJECTIVE
  To evaluate whether the administration of local anesthetic (LA) reduces pain in comparison with forced coughing (FC) for the execution of colposcopically guided biopsies (CGBs).
  
  
  METHODS
  Data of 100 consecutive patients undergoing CGBs with the use of LA or FC were prospectively evaluated. Procedure-related pain was assessed with the use of a 100-mm visual analogue scale.
  
  
  RESULTS
  Fifty-one and 49 patients had CGBs using LA and FC, respectively. No between-group differences were observed in terms of pain related to speculum insertion, CGBs and pain recorded after the procedures (p>0.05). However, patients in the LA group experienced pain related to cervical injection for administration of anesthesia (mean (±SD): 12.4 (±1.6)). Operative time was longer in the LA than in the FC group (7.2 (±0.2) vs. 5.0 (±0.1)min; p<0.001).
  
  
  CONCLUSIONS
  FC should be preferred over LA. Although CGB-related pain levels do not differ, the omission of intracervical injection is associated with undoubted advantages.
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy. Electronic address: giorgiobogani@yahoo.it.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bogani
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Serati
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Cromi
authors.affiliation: Department of Obstetrics and Gynecology, University of Bari, Bari, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Di Naro
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
authors.forename: Jvan
authors.initials: J
authors.lastname: Casarin
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Pinelli
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
authors.forename: Thomas
authors.initials: T
authors.lastname: Rossi
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
mesh_terms: D000328:Adult; D000368:Aged; D000772:Anesthesia, Local / Q000009:adverse effects; D001706:Biopsy / Q000009:adverse effects; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy / Q000009:adverse effects; D003371:Cough; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008875:Middle Aged; D061646:Operative Time; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D058748:Pain Perception; D011446:Prospective Studies; D055815:Young Adult
keywords: Cervical biopsy; Cervical dysplasia; Colposcopy; Forced coughing; Local anesthesia