The effect of an intrauterine application of two percent lignocaine gel on pain perception during Vabra endometrial sampling: a randomised double-blind, placebo-controlled trial


* Mr E.L. Kozman, Department of Obstetrics and Gynaecology, Warrington Hospital NHS Trust, Lovely Lane, Warrington WA5 1QG, UK


Objective To determine whether two percent lignocaine gel can reduce the perception of pain during Vabra endometrial aspiration.

Design Randomised, double-blind placebo-controlled trial.

Setting Women's Health Directorate, Warrington Hospital NHS Trust.

Population Women were referred to the endometrial sampling clinic for the investigation of pre and postmenopausal vaginal bleeding.

Methods Randomisation to either pre-sampling intrauterine two percent lignocaine gel or an inert gel. Patients, recruiters and assessors were blinded to the gel used.

Main outcome measures The difference between the study groups in the proportion of women who, after Vabra sampling, recorded a pain score of ≥6 out of 10 on a visual analogue scale.

Results Three hundred and eight women were randomised, 284 (92%) completed a pain scale before and immediately after the procedure. After the procedure, 84 women (30%) recorded a pain score of ≥6, 38 (26%) received anaesthetic and 46 (33%) an inert gel. The difference in the proportion of women recording a pain score of 6 or above between the two study groups was not significant (relative risk (RR) for the anaesthetic gel=0.79 95% CI, 0.55, 1.14).

Conclusions Intrauterine application of 2% lignocaine gel did not significantly reduce the frequency with which women experienced unacceptable levels of pain or anxiety during endometrial aspiration compared with placebo.