OC046: The addition of lidocaine to the gel used for gel infusion sonography (GIS): Effect on pain perception during GIS and subsequent hysteroscopy and endometrial sampling

Abstract

To evaluate if the addition of lidocaine to the gel used for gel infusion sonohysterography (GIS) influences the pain experienced during GIS, or during subsequent hysteroscopy and endometrial sampling. One hundred forty two consecutive patients presenting at the department's One Stop Bleeding Clinic were randomized before undergoing GIS: 79 patients received a gel with lidocaine (Instillagel), 63 patients received a gel without lidocaine (Endosgel). Immediately after GIS the patients underwent office hysteroscopy and endometrial sampling. After each examination the women were asked to fill in a questionnaire about their pain perception during that examination. The mean age (SD) was 50.8 (12.1) years; 58.5% were premenopausal with 15.6% nulliparous. The mean (SD) visual analogue scale (VAS) score during GIS was 16.5 (21.5): 18.1 (22.7) for the lidocaine group versus 14.0 (19.4) for those who received gel without lidocaine. The mean (SD) VAS scores during hysteroscopy in the total group, the Instillagel group and the Endosgel group were 27.6 (28), 27.4 (26.7) and 27.9 (30.3), respectively. The mean (SD) VAS scores during endometrial sampling were 33.6 (30.3), 33.0 (29.6) and 34.8 (32), respectively. The addition of lidocaine to the gel used either for for GIS or prior to office hysteroscopy and endometrial sampling does not improve the procedure related pain.