Topical anaesthesia for diagnostic hysteroscopy and endometrial biopsy in postmenopausal women: A randomised placebo-controlled double-blind study

Objective To evaluate the efficacy and safety of topical anaesthesia in reducing pain and incidence of vasovagal reactions during diagnostic hysteroscopy with endometrial biopsy in postmenopausal women. Design Randomised placebo-controlled double-blind study. Setting University hospital. Participants Eighty postmenopausal women undergoing diagnostic hysteroscopy and endometrial biopsy. Interventions Two millilitres of 2% mepivacaine or saline solution were injected transcervically into the uterine cavity before performing the procedures. Main outcome measures Evaluation of pain reduction on a visual analogue scale and continuous monitoring of heart rate and blood pressure. Results The use of the anaesthetic significantly reduced the pain experienced at hysteroscopy and endometrial biopsy. The occurrence of vasovagal reactions was significantly lower in the anaesthetised group. Conclusions Topical anaesthesia attenuated pain and effectively prevented the occurrence of vasovagal reactions during hysteroscopy and endometrial biopsy in postmenopausal women.