Forced coughing versus local anesthesia and pain associated with cervical biopsy: a randomized trial

Am J Obstet Gynecol. 2008 Dec;199(6):641.e1-3. doi: 10.1016/j.ajog.2008.07.017. Epub 2008 Sep 25.

Abstract

Objective: Cervical biopsy often causes discomfort and pain. To compare local anesthesia (1% lidocaine) with forced coughing as pain relief, we quantified the actual pain experienced during cervical punch biopsies.

Study design: For a prospective trial conducted at the Medical University of Vienna, 68 women undergoing cervical punch biopsies for assessment of abnormal cervical smears were randomized in 2 pain relief treatment groups. Patients' discomfort was assessed immediately after taking the biopsy using at 10-cm visual analog scale.

Results: No statistically significant difference was found between pain scores recorded for the 2 groups (P = .47, 95% confidence interval [CI], -0.4 to 1.3 cm). However, when local anesthesia was applied, the examination was significantly prolonged by a median of 2.11 min (P < .001; 95% CI, 1.6-2.8).

Conclusion: Forced coughing during cervical biopsies reduces patients' discomfort to the same extent as local anesthesia, but is associated with a significantly reduced examination time.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anesthesia, Local / methods
  • Biopsy, Needle / methods*
  • Cervix Uteri / pathology*
  • Confidence Intervals
  • Cough*
  • Female
  • Humans
  • Lidocaine / administration & dosage*
  • Middle Aged
  • Pain / prevention & control*
  • Pain Measurement
  • Patient Satisfaction
  • Probability
  • Prospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Statistics, Nonparametric
  • Treatment Outcome
  • Young Adult

Substances

  • Lidocaine