Lignocaine aerosol spray in outpatient hysteroscopy: a randomized double-blind placebo-controlled trial.

ABSTRACT

OBJECTIVE: To assess the efficacy of lignocaine spray during outpatient hysteroscopy in reducing the need for additional anesthesia and reducing the discomfort of the procedure. DESIGN: A randomized double-blind, placebo-controlled trial. SETTING: An undergraduate university teaching hospital in London. PATIENT(S) One hundred twenty patients undergoing outpatient hysteroscopy. INTERVENTION(S) Application of lignocaine spray to the cervix, cervical canal, and uterine cavity during outpatient hysteroscopy. MAIN OUTCOME MEASURE(S) The need to use additional anesthesia and the pain experienced at various steps of the procedure. RESULT(S) Women treated with active spray experienced significantly less pain when the cervix was grasped with a tenaculum at the start of hysteroscopy. There were no other significant differences in the outcome of hysteroscopy between the placebo and lignocaine groups, although there was a significant reduction in the use of additional anesthesia in both groups compared with historical controls. CONCLUSION(S) Lignocaine spray has beneficial effects on cervical but not uterine sensation. Pretreatment with either lignocaine or placebo seems to reduce the need for additional intracervical anesthesia during hysteroscopy.