A randomised double-blind placebo-controlled trial of transcervical intrauterine local anaesthesia in outpatient hysteroscopy.

OBJECTIVE: To assess whether transcervical intrauterine instillation of local anaesthetic agent reduces pain during diagnostic outpatient hysteroscopy and endometrial biopsy.

DESIGN: Prospective, randomised, double blind, placebo-controlled trial.

SETTING: Outpatient hysteroscopy clinic in a university teaching hospital.

POPULATION: Ninety women undergoing outpatient diagnostic hysteroscopy with or without endometrial biopsy.

METHODS: Transcervical intrauterine instillation of 5 mL of 2% lignocaine into the uterine cavity before performing the procedure.

MAIN OUTCOME MEASURES: Evaluation of pain at different stages of the procedure using a visual analogue scale and changes in blood pressure and heart rate.

RESULTS: The use of local anaesthetic did not alleviate pain experienced during hysteroscopy and endometrial biopsy. It did not prevent the occurrence of vaso-vagal reactions; however the incidence of these was low.

CONCLUSIONS: Transcervical instillation of local anaesthesia neither reduced pain nor prevented vaso-vagal reaction during hysteroscopy and endometrial biopsy.