Piyawetchakarn Ratpaporn, Charoenkwan Kittipat
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Obstet Gynaecol Res. 2019 May;45(5):987-993. doi: 10.1111/jog.13932. Epub 2019 Feb 7.
To examine the effect of lidocaine spray for reducing pain during endometrial aspiration biopsy by comparing it with placebo and no intervention.
Women undergoing endometrial aspiration biopsy from March 2017 to January 2018 were invited to participate. The participants were randomly assigned into three groups. In group 1 (lidocaine spray), eight puffs (80 mg, 10 mg/puff, 0.8 mL) of 10% lidocaine spray was applied thoroughly to the cervix, 3 min before starting the procedure. For group 2 (placebo spray), 0.8 mL of normal saline spray was applied to the cervix, 3 min before starting the procedure. For group 3 (no intervention), no anesthesia was given. The patients rated their pain according to a 10-cm visual analog scale at different points including baseline, immediately after the procedure (biopsy pain), and 10 min after the procedure. The 10-cm visual analog scale on satisfaction was also rated before hospital discharge. Comparison of continuous variables was made by using Kruskal-Wallis test. Chi squared test was used for comparison of categorical variables.
Two hundred and forty patients (80 in each group) participated. The mean baseline, biopsy and postprocedural pain scores were not significantly different among the study groups. Similarly, the mean difference between the biopsy and the baseline pain scores were comparable among the groups. In addition, there was no difference on the satisfaction scores among the groups.
Lidocaine spray applied to the cervix is not effective for reducing pain associated with pipelle endometrial aspiration biopsy.
通过将利多卡因喷雾与安慰剂及无干预措施进行比较，研究其在子宫内膜抽吸活检过程中减轻疼痛的效果。
邀请2017年3月至2018年1月期间接受子宫内膜抽吸活检的女性参与研究。参与者被随机分为三组。第1组（利多卡因喷雾组）在开始操作前3分钟，将8喷（80毫克，每喷10毫克，0.8毫升）10%的利多卡因喷雾充分喷于宫颈。第2组（安慰剂喷雾组）在开始操作前3分钟，将0.8毫升生理盐水喷雾喷于宫颈。第3组（无干预组）不给予麻醉。患者在不同时间点，包括基线、操作后即刻（活检疼痛）和操作后10分钟，根据10厘米视觉模拟量表对疼痛进行评分。出院前还对满意度进行了10厘米视觉模拟量表评分。连续变量的比较采用Kruskal-Wallis检验。分类变量的比较采用卡方检验。
240名患者（每组80名）参与研究。各研究组的平均基线、活检及操作后疼痛评分无显著差异。同样，各组活检与基线疼痛评分之间的平均差异相当。此外，各组满意度评分也无差异。
喷于宫颈的利多卡因喷雾对减轻与 Pipelle 子宫内膜抽吸活检相关的疼痛无效。
