A comparison of the side effects of prilocaine with felypressin and lignocaine with adrenaline in large loop excision of the transformation zone of the cervix: results of a randomised trial

Objective: To test the hypothesis that prilocaine with felypressin causes f ewer side effects than lignocaine with adrenaline when performing large loo p excision of the transformation zone of the cervix. Design: Randomised trial. Setting: Colposcopy clinic in a large district general hospital. Participants: Two hundred consecutive women undergoing large loop excision of the transformation zone of the cervix. Methods: Two different local anaesthetic combinations (prilocaine with fely pressin and lignocaine with adrenaline) were compared in women undergoing l arge loop excision of the transformation zone. Prospective collection of cl inical and treatment data was undertaken with scoring using an ordinal scal e of pain experienced by the women during the procedure. Peri-operative blo od loss and any side effects were also recorded. Main outcome measures: Side effects associated with the local anaesthetic a gents. Results: Lignocaine with adrenaline resulted in less blood loss (P = 0.006) but was more likely to cause side effects, such as feeling faint (P = 0.01 7) and shaking (P < 0.001). Conclusion: Prilocaine with felypressin causes fewer side effects than lign ocaine with adrenaline and is therefore the preferred local anaesthetic com bination for large loop excision of the transformation zone.