Photo Credit: Mohammed Haneefa Nizamudeen

The following is a summary of “Optimizing analgesia for endometrial biopsy: A prospective, randomized comparative study,” published in the November 2024 issue of Obstetrics and Gynecology by Coskun et al.        

Endometrial biopsy (EMB) can cause significant discomfort. Different analgesic methods are used to manage pain during this procedure.  

Researchers conducted a prospective study to compare the effectiveness of 4 pain management methods during EMB.  

They involved 197 women (aged 18–75) undergoing EMB to receive either intrauterine lidocaine (n = 49), oral dexketoprofen (n = 48), cervical lidocaine spray (n = 50), or paracervical block with prilocaine (n = 50). Pain intensity was measured using a visual analog scale (VAS) immediately after the procedure and at 30 minutes, with additional analgesia recorded at 60 minutes. Statistical analysis included Kruskal–Wallis and chi-square tests.  

The results showed that intrauterine lidocaine had the lowest pain scores, while oral dexketoprofen had the highest scores (P<0.001). Intrauterine lidocaine and paracervical block were significantly more effective than cervical lidocaine spray and oral dexketoprofen (P<0.001). The cervical lidocaine spray group required additional analgesia in 30% of cases, while no additional analgesia was needed in the other groups. Severe pain (VAS ≥5.8) was more frequent in the dexketoprofen group compared to others (P<0.001).  

They concluded that intrauterine lidocaine and paracervical block were more effective than cervical lidocaine spray and oral dexketoprofen for pain relief during EMB.  

Source: obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/jog.16148