Analgesia for colposcopy: Double-masked, randomized comparison of ibuprofen and benzocaine gel

Objective: To evaluate pain relief effectiveness of oral ibuprofen and topi cal benzocaine gel during colposcopy. Methods: In a double-masked, randomized controlled trial, women who attende d a family medicine colposcopy clinic received one of four treatments, 800 mg of oral ibuprofen, 20% topical benzocaine, both, or placebos. Using visu al analog scales, women recorded their pain after speculum placement, endoc ervical curettage (ECC), and cervical biopsy. Participants were 18-55 years old, spoke English, and were not taking other pain or psychotropic medicat ions. Demographic and historical information was collected from each partic ipant. Results: Ninety-nine subjects participated. Twenty-five received oral ibupr ofen and topical benzocaine (median pain scores on a 10-point scale for spe culum placement, ECC, and biopsy were 0.75, 3.00, and 3.38, respectively), 24 received oral placebo and topical benzocaine (1.00, 3.75, and 2.63), 24 received oral ibuprofen and topical placebo (0.63, 3.75, and 2.25), and 26 received oral and topical placebos (0.75, 3.50, and 3.00). There were no st atistically significant differences in patient visual analogue pain scale s cores across the four groups (statistical power, ECC = 0.74, cervical biops y = 0.62). Younger women and women who had pain with speculum placement wer e more likely to have increased pain during ECC. Increased pain during biop sy was associated with history of severe dysmenorrhea but no other demograp hic or historical factors. Women overall reported ECC and biopsy to be mild ly painful, with median scores of 3.5 for ECC and 2.75 for biopsy on a 10-p oint scale. The range in pain scores was large, with some women reporting s evere pain (for ECC minimum = 0.25, maximum = 10.0; biopsy: minimum = 0.0, maximum = 9.0). Conclusion: Colposcopy is perceived as somewhat painful, but oral ibuprofen and topical benzocaine gel, alone or together, provided no advantage over placebo in decreasing colposcopy pain. (Obstet Gynecol 2001;97:5-10, (C) 20 01 by The American College of Obstetricians and Gynecologists.)