Topical anaesthesia for diagnostic hysteroscopy and endometrial biopsy in postmenopausal women: a randomised placebo-controlled double-blind study

OBJECTIVE: To evaluate the efficacy and safety of topical anaesthesia in reducing pain and incidence of vasovagal reactions during diagnostic hysteroscopy with endometrial biopsy in postmenopausal women.

DESIGN: Randomised placebo-controlled double-blind study.

SETTING: University hospital.

PARTICIPANTS: Eighty postmenopausal women undergoing diagnostic hysteroscopy and endometrial biopsy.

INTERVENTIONS: Two millilitres of 2% mepivacaine or saline solution were injected transcervically into the uterine cavity before performing the procedures.

MAIN OUTCOME MEASURES: Evaluation of pain reduction on a visual analogue scale and continuous monitoring of heart rate and blood pressure.

RESULTS: The use of the anaesthetic significantly reduced the pain experienced at hysteroscopy and endometrial biopsy. The occurrence of vasovagal reactions was significantly lower in the anaesthetised group.

CONCLUSIONS: Topical anaesthesia attenuated pain and effectively prevented the occurrence of vasovagal reactions during hysteroscopy and endometrial biopsy in postmenopausal women.