Local anesthetic versus forced coughing at colposcopic-guided biopsy: a prospective study.

OBJECTIVE

To evaluate whether the administration of local anesthetic (LA) reduces pain in comparison with forced coughing (FC) for the execution of colposcopically guided biopsies (CGBs).

STUDY

DESIGN

Data of 100 consecutive patients undergoing CGBs with the use of LA or FC were prospectively evaluated. Procedure-related pain was assessed with the use of a 100-mm visual analogue scale.

RESULTS

Fifty-one and 49 patients had CGBs using LA and FC, respectively. No between-group differences were observed in terms of pain related to speculum insertion, CGBs and pain recorded after the procedures (p>0.05). However, patients in the LA group experienced pain related to cervical injection for administration of anesthesia (mean (±SD): 12.4 (±1.6)). Operative time was longer in the LA than in the FC group (7.2 (±0.2) vs. 5.0 (±0.1)min; p<0.001).

CONCLUSIONS

FC should be preferred over LA. Although CGB-related pain levels do not differ, the omission of intracervical injection is associated with undoubted advantages.