The use of topical anesthesia in diagnostic hysteroscopy and endometrial biopsy.

STUDY OBJECTIVE

To determine whether the pain and discomfort of routine hysteroscopy with endometrial biopsy to diagnose infertility and endometrial pathology can be minimized by topical application of mepivacaine.

DESIGN

Prospective, randomized, double-blind study.

SETTING

The Department of Obstetrics and Gynecology at a teaching hospital in Rome, Italy.

PATIENTS

Eighteen women undergoing diagnostic hysteroscopy.

INTERVENTIONS

Hysteroscopy and endometrial biopsy were performed after transcervical injection of 5 ml 2% mepivacaine or 5 ml saline solution into the uterine cavity.

MEASUREMENTS AND MAIN RESULTS

Difficulty introducing the hysteroscope was rated by the operator on a scale of 1 to 3. An observer scored visible signs of each woman's distress using a three-point scale. The patients reported their pain 15, 30, 60, 120 minutes after the procedure on a visual analog scale. Mepivacaine was more effective than placebo according to all measurements.

CONCLUSIONS

Topical mepivacaine reduced the pain experienced during and after hysteroscopy and endometrial biopsy.