Lignocaine aerosol spray in outpatient hysteroscopy: a randomized double-blind placebo-controlled trial

OBJECTIVE: To assess the efficacy of lignocaine spray during outpatient hysteroscopy in reducing the need for additional anesthesia and reducing the discomfort of the procedure.

DESIGN: A randomized double-blind, placebo-controlled trial.

SETTING: An undergraduate university teaching hospital in London.

PATIENT(S): One hundred twenty patients undergoing outpatient hysteroscopy.

INTERVENTION(S): Application of lignocaine spray to the cervix, cervical canal, and uterine cavity during outpatient hysteroscopy.

MAIN OUTCOME MEASURE(S): The need to use additional anesthesia and the pain experienced at various steps of the procedure.

RESULT(S): Women treated with active spray experienced significantly less pain when the cervix was grasped with a tenaculum at the start of hysteroscopy. There were no other significant differences in the outcome of hysteroscopy between the placebo and lignocaine groups, although there was a significant reduction in the use of additional anesthesia in both groups compared with historical controls.

CONCLUSION(S): Lignocaine spray has beneficial effects on cervical but not uterine sensation. Pretreatment with either lignocaine or placebo seems to reduce the need for additional intracervical anesthesia during hysteroscopy.