Stepwise pain score analysis of the effect of local lignocaine on outpatient hysteroscopy: a randomized, double-blind, placebo-controlled trial.

OBJECTIVE: To assess the efficacy of lignocaine gel in reducing the overall pain and pain of individual steps during outpatient hysteroscopy in comparison with placebo (no anesthesia).

DESIGN: A prospective, randomized, double-blind, placebo-controlled trial.

SETTING: Outpatient hysteroscopy clinic in a regional hospital in Hong Kong.

PATIENT(S): A total of 500 Chinese patients undergoing outpatient hysteroscopy.

INTERVENTION(S): Application of lignocaine gel to the cervix during outpatient hysteroscopy.

MAIN OUTCOME MEASURE(S): Mean pain score using present pain intensity, overall pain score measured by total area under the curve, and the pain score of individual steps in the procedure in patients receiving lignocaine gel were compared with those of patients having no anesthesia. The failure rate and poor-view rate in both groups were also compared.

RESULT(S): There were no statistically significant differences in mean pain score, overall pain score, and pain score of individual steps between the lignocaine group and controls. The failure rate and poor-view rate also showed no statistically significant differences.

CONCLUSION(S): Outpatient hysteroscopy without anesthesia is acceptable to most Chinese women, and the local application of lignocaine gel is not effective in reducing pain.