INEFFECTIVENESS OF TOPICAL BENZOCAINE SPRAY DURING COLPOSCOPY

BACKGROUND. Colposcopic evaluation can cause patients to experience pa in and anxiety. This study investigated the use of benzocaine spray, a topical anesthetic, and its effects on pain and anxiety associated wi th colposcopy and colposcopic biopsy, METHODS. The study was a double- blind, placebo-controlled trial of the effectiveness of benzocaine spr ay applied to the cervix immediately before colposcopic examination, c ervical biopsy, or endocervical curettage in patients of a family prac tice center. Prior to the gynecologic procedure the patient's cervix w as sprayed with either benzocaine spray or matching placebo spray. Aft er waiting at least 30 seconds the clinician started the procedure. Pa in and anxiety, measured on 10-cm visual analog scales, were determine d at the following times: (1) before the start of the gynecologic exam ination; (2) immediately before using the spray; (3) immediately after using the spray; and, (4) after the procedure was completed. RESULTS. Of 58 consecutive patients who underwent colposcopy, 36 patients were eligible for the trial and were evaluated. Participants were similar to patients not participating with regard to race, gravidity, and pari ty. Statistical analysis found significant differences in both pain an d anxiety scores over time (repeated measures multivariate ANOVA, P <. 0001), but no difference between the use of active drug and placebo. P ain scores increased significantly after application of either benzoca ine or placebo spray before the start of the procedure (average increa se 1.3 cm, P <.0001). CONCLUSIONS. Benzocaine, in a spray vehicle, con fers no benefit when used to decrease pain and anxiety in women underg oing colposcopic procedures.