This study was conducted to investigate the efficacy of intrauterine lidocaine plus naproxen sodium in controlling pain associated with endometrial biopsy using the Pipelle instrument. One hundred twenty women scheduled to undergo endometrial biopsy were randomly assigned to 1 of 4 different anesthetic regimens consisting of 5 mL of intrauterine 2% lidocaine or saline plus 550 mg naproxen sodium or placebo. The amount of pain experienced during biopsy was evaluated with 2 subjective measures. Physicians noted the patient’s visible signs of discomfort on a 3-point observer scale during the procedure, and patients completed a 10-cm visual analog scale of pain perception after the procedure. The intrauterine lidocaine or the saline solution was administered using a transcervical 18-gauge angiocatheter approximately 60 minutes before the procedure. In addition, at this time, each woman was given oral medication of either 550 mg sodium naproxen or a placebo similar in appearance. Neither the patient nor the physician was aware of the treatment group. Women who were given saline plus a placebo experienced the most pain (approximately 6.5 on the 10-point scale). Those in the intrauterine lidocaine only or sodium naproxen-only groups had 17% and 18%, respectively, lower pain scores than those who had no anesthetic; but the difference did not reach significance (P >0.05). However, patients in the lidocaine plus sodium naproxen group had a 35% reduction in pain compared with those who had no anesthetic (P <0.001). This group also reported less pain than those who had either lidocaine or sodium naproxen alone, but, again, the difference was not significant (P >0.05). Physician reports of perceived pain correlated with the patient analog scale in all 4 groups. The only reported side effect was a postprocedure vasovagal reaction in 1 woman from the naproxen-only group.
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Doğan et al. (2004) studied this question.