Transcervical intrauterine topical local anesthetic at hysterosalpingography: a prospective, randomized, double-blind, placebo-controlled trial

Objective: To assess whether transcervical intrauterine topical instillation of a local anesthetic agent reduces pain at hysterosalpingography. Design: Prospective, randomized, double-blind, placebo-controlled study. Setting: Department of reproductive medicine at a university teaching hospital. Patient(s): One hundred ten women undergoing hysterosalpingography (HSG). Intervention(s): Subjects were randomized to receive either 2 mL of 2% plain lignocaine or 2 mL of 0.9% sodium chloride solution (placebo) topically into the uterine cavity before the HSG was performed. Main Outcome Measure(s): The degree of lower abdominal pain experienced both during the injection of contrast media at HSG and 10 minutes after the procedure using a 20-cm visual analogue scale (VAS) and a four-point verbal descriptor scale (VDS). Result(s): There was no difference in pain scores between lignocaine and placebo during the HSG. However, at 10 minutes after the HSG, subjects receiving lignocaine experienced more pain than those on placebo. Conclusion(s): Transcervical intrauterine topical instillation of 2 mL of 2% plain lignocaine does not reduce pain during HSG and may lead to increased pain immediately after the procedure.