Anesthetic efficacy of intrauterine lidocaine for endometrial biopsy: a randomized double-masked trial

Abstract

Objective: To determine the efficacy of intrauterine lidocaine for decreasing pain associated with endometrial biopsy using the Pipelle instrument (Unimar; Wilton, CT).

Methods: Forty-one premenopausal and postmenopausal women had 5 mL of either 2% lidocaine or saline instilled in their uteri before endometrial biopsies. Subsequently, each woman completed a 20-cm visual analogue scale for subjective pain experience. We compared histologic findings in endometrial specimens.

Results: Before the study, analysis of specimens (n = 6) found no histologic effect on ability to interpret endometrial biopsies by pathologists who were masked to lidocaine or saline. There was no statistically significant difference in age, parity, race, history of chronic pelvic pain, menopausal status, use of tenaculum, or prior endometrial biopsy. The procedure was easy, with no clinically significant side effects. On the visual pain scale, the median (range) score for the lidocaine group (4.7, 0-19.7) compared with the placebo group (9.9, 1.6-20) showed significant reduction in pain corresponding with a decrease from moderate to mild (P < .01).

Conclusion: Intrauterine lidocaine is simple and effective for decreasing pain associated with the Pipelle endometrial biopsy.