THE USE OF TOPICAL ANESTHESIA IN DIAGNOSTIC HYSTEROSCOPY AND ENDOMETRIAL BIOPSY

Study Objective. To determine whether the pain and discomfort of routi ne hysteroscopy with endometrial biopsy to diagnose infertility and en dometrial pathology can be minimized by topical application of mepivac aine. Design. Prospective, randomized, double-blind study. Setting. Th e Department of Obstetrics and Gynecology at a teaching hospital in Ro me, Italy. Patients. Eighteen women undergoing diagnostic hysteroscopy . Interventions. Hysteroscopy and endometrial biopsy were performed af ter transcervical injection of 5 ml 2% mepivacaine or 5 ml saline solu tion into the uterine cavity. Measurements and Main Results. Difficult y 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 usi ng a three-point scale. The patients reported their pain 15, 30, 60, a nd 120 minutes after the procedure on a visual analog scale. Mepivacai ne was more effective than placebo according to all measurements. Conc lusions. Topical mepivacaine reduced the pain experienced during and a fter hysteroscopy and endometrial biopsy.