Mepivacaine Local Cervical Anesthesia for Diagnostic Hysteroscopy: A Randomized Placebo-Controlled Study

Abstract

The purpose of this study was to evaluate the efficacy and safety of local cervical application of mepivacaine hydrochloride for reducing pain associated with hysteroscopy. Among the patients who underwent hysteroscopic evaluation over a 6-year period (1994-1999) at the hysteroscopy unit of the First Department of Obstetrics and Gynecology of the University of Athens, in 245 anesthesia was necessary. In 45 patients, general anesthesia was decided on, for various reasons. The remaining 200 patients were randomized into two groups of 100. Patients of the study group were given local anesthesia by local cervical injection of mepivacaine hydrochloride, and patients in the control group received normal saline injection. All patients evaluated their pain, using an 11-point (0-10) analog scale, during the procedure as well as 30 and 60 min afterward. The use of local mepivacaine effectively and safely reduced pain associated with hysteroscopy and endometrial biopsy, as the mean value of pain assessment in the study group was notably inferior to that reported by the control group. Still, when unpaired Student's t test was applied for statistical evaluation, the difference was statistically nonsignificant.