Role of Local Anesthetics on Pain Relief in Endometrial Biopsy: Randomized Clinical Trial

Objectives: Endometrial biopsy is necessary for diagnosing the reason of abnormal uterine bleeding in perimenopausal women. Currently outpatient endometrial biopsy is used for evaluation of abnormal uterine bleeding which is associated with moderate to severe pain. Using lidocaine is one of the procedures which is used for pain relief while biopsy. This study is aimed at comparing the effect of different local anesthesia procedures on pain relief during endometrial biopsy. Materials and Methods: In this randomized clinical trial, 160 multiparous 40-55 years old women with AUB (Abnormal Uterine Bleeding), candidates for endometrial biopsy, were randomly assigned into four equal groups, to receive: 1-intrauterine lidocaine; 2-cervical spray lidocaine; 3intrauterine lidocaine plus cervical spray lidocaine; or 4-intrauterine distilled water. Pain relief was measured at 3 different times: during endometrial biopsy, just after and 15 minutes after biopsy. Results: Pain intensity was reduced significantly at different times in intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine receivers in compare with the groups which received cervical spray lidocaine and distilled water. The mean of difference pain relief during biopsy and 15 minutes after that was reduced significantly in the group which received intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine in comparison with the other two groups. Conclusion: Intrauterine lidocaine was effective during endometrial biopsy, and using it with cervical spray lidocaine had no more beneficial effect. 1Associate Professor of Ob & Gyn, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 2Professor of Ob & Gyn, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 3Resident of Ob & Gyn, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 4Associate Professor of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran. Article History: Received 9 October 2013 Accepted 7 January 2014 Revised 25 December 2013 Available online 7 January 2014 Corresponding Author: Elaheh Ouladsahebmadarek, Associate Professor of Ob & Gyn, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.