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Objective To assess whether transcervical intrauterine instillation of local anaesthetic agent reduces pain during diagnostic outpatient hysteroscopy and endometrial biopsy.

Design Prospective, randomised, double blind, placebo-controlled trial.

Setting Outpatient hysteroscopy clinic in a university teaching hospital.

Population Ninety women undergoing outpatient diagnostic hysteroscopy with or without endometrial biopsy.

Methods Transcervical intrauterine instillation of 5 mL of 2% lignocaine into the uterine cavity before performing the procedure.

Main outcome measures Evaluation of pain at different stages of the procedure using a visual analogue scale and changes in blood pressure and heart rate.

Results The use of local anaesthetic did not alleviate pain experienced during hysteroscopy and endometrial biopsy. It did not prevent the occurrence of vaso-vagal reactions; however the incidence of these was low.

Conclusions Transcervical instillation of local anaesthesia neither reduced pain nor prevented vasovagal reaction during hysteroscopy and endometrial biopsy.