From the Research
Analgesics for Colposcopy Procedure
The following analgesics have been studied for pain relief during colposcopy procedures:
- Lidocaine spray: Applied to the cervix, it has been shown to reduce pain associated with colposcopy-directed cervical biopsies 1
- Local anaesthetic infiltration (lignocaine 2%): Administered as a paracervical or direct cervical injection, it has been compared to a saline placebo with no significant difference in pain relief 2, 3
- Local anaesthetic with a vasoconstrictor agent (lignocaine plus adrenaline or prilocaine plus felypressin): Significantly less pain occurred compared to no treatment 2, 3
- Oral analgesics (non-steroidal anti-inflammatory drugs (NSAIDs)): No significant difference in pain relief compared to placebo or no treatment 2, 3, 4
- Topical benzocaine gel: No advantage over placebo in decreasing colposcopy pain 4
- Topical lignocaine gel: Did not significantly relieve pain from cervical punch biopsy, but may be beneficial to a subgroup of women with prior unpleasant experience towards speculum examination 5
- Cocaine spray: Associated with less pain and blood loss than placebo 2, 3
- Inhalation analgesia (gas mixture of isoflurane and desflurane): Resulted in less pain during the LLETZ procedure when used in addition to standard cervical injection with prilocaine plus felypressin 2, 3
Key Findings
- Intracervical injection of local anaesthetic with a vasoconstrictor (lignocaine plus adrenaline or prilocaine plus felypressin) appears to be the optimum analgesia for treatment 2, 3
- Further high-quality, adequately powered trials are needed to estimate the efficacy of oral analgesics, the optimal route of administration and dose of local anaesthetics 2, 3