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, and 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.