• W C Lau, W K Lo, W H Tam, and P M Yuen.
• Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories.
• Br J Obstet Gynaecol. 1999 Apr 1; 106 (4): 356-9.

ObjectiveTo evaluate the efficacy and safety of paracervical anaesthesia in reducing pain during outpatient hysteroscopy and endometrial biopsy.DesignProspective, randomised, placebo-controlled, double-blind study.PopulationOne hundred women undergoing outpatient hysteroscopy and endometrial biopsy for abnormal uterine bleeding.InterventionsParacervical block using 10 mL of either 2% lignocaine or normal saline before the procedure.Main Outcome MeasuresEvaluation of pain at different stages of hysteroscopy using a visual analogue scale together with blood pressure and heart rate monitoring.ResultsCompared with placebo, paracervical anaesthesia significantly reduced the pain only at the time of insertion of the hysteroscope, but not at the subsequent stages of the procedure. However, paracervical injection of lignocaine resulted in a higher incidence of bradycardia and hypotension.ConclusionsParacervical anaesthesia not only fails to reduce pain during outpatient hysteroscopy and endometrial biopsy, but also carries a risk of inducing bradycardia and hypotension, which is probably a result of inadvertent intravascular injection.

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