Does local anesthesia at mid-trimester amniocentesis decrease pain experience? A randomized trial in 220 patients

Objectives To evaluate whether local anesthesia decreases patients' pain experience during mid-trimester amniocentesis. Methods In a randomized trial, one group did not receive local anesthesia while, in another group, lignocaine 1% was injected subcutanously prior to amniocentesis. Five different scoring systems were used to evaluate patients' pain experience. Results Two hundred and twenty women entered the study: 114 received local anesthesia, while 106 did not. The mean (SD) Visual Analog Scale was 1.4 (1.5) on a 0-10 scale (range 0-76). Some 97% of patients described the procedure as not painful or bearable, 79% had expected the procedure to be more painful and 59% reported the amniocentesis to have a comparable discomfort as venous blood sampling; 98% of women declared they would undergo an amniocentesis again if indicated. There were no statistical differences between both randomization groups. Conclusions Mid-trimester amniocentesis is not a painful procedure. Local anesthesia does not affect pain experience during amniocentesis.