Atraumatic cervical passage at outpatient hysteroscopy

Objective: To evaluate the efficacy of topical anesthesia routinely administered to reduce discomfort and the need for additional local anesthesia during outpatient hysteroscopy. Design: Comparative observational study. Setting: Outpatient hysteroscopy clinic in a University hospital. Patient(s): Three hundred patients undergoing outpatient hysteroscopy. Intervention(s): Application of lidocaine spray both to the surface of the cervix and into the cervical canal before performing hysteroscopy. Main Outcome Measure(s): The discomfort during passage of the hysteroscope through the cervical canal, the need for additional local anesthesia, and the failure rate of outpatient hysteroscopy. Result(s): One hundred fifty consecutive patients receiving lidocaine spray before the hysteroscopy were compared to a control group of another 150 consecutive patients who underwent the examination without pretreatment. Women treated with spray experienced significantly less pain at insertion of the hysteroscope. Furthermore, the spray significantly reduced both the need for additional anesthesia and the rate of failed hysteroscopies due to intolerable pain. Conclusion(s): Topical anesthesia with lidocaine spray is a simple method to alleviate patients' discomfort during cervical passage. It is effective in reducing the need for local anesthesia and should reduce the rate of failed outpatient hysteroscopies. (C) 1998 by American Society for Reproductive Medicine.