Efficacy of intrauterine lignocaine plus vaginal misoprostol for pain relief in premenopausal women undergoing endometrial aspiration and ambulatory hysteroscopy

Abstract

To compare the effectiveness of a combination of intrauterine lignocaine and vaginal misoprostol in reducing pain at hysteroscopy and endometrial aspiration (EA). Prospective randomized trial (Canadian Task Force Classification I). Tertiary care referral hospital. Forty-nine premenopausal women undergoing hysteroscopy plus EA. Patients were randomized into misoprostol plus intrauterine lignocaine group (Group I) and only misoprostol group (Group II). Pain scores at hysteroscope insertion (T (time) 1), during and after hysteroscopy (T2, T3), during EA (T4), 15 minutes after the procedure (T5) and at discharge (T6). Satisfaction and procedure acceptability was assessed by a questionnaire. The mean age of patients in Group I and Group II was 35.4 +/- 8.6 years and 38.9 +/- 13.2 years, respectively. The mean pain scores in Group I were 23.6% lower at T2 and 27% lower at T4 when compared with Group II; the difference of latter being significant. A combination of intrauterine lignocaine plus vaginal misoprostol reduced the pain score in premenopausal women undergoing hysteroscopy and EA.