Comparison of Lignocaine Spray Versus Lignocaine Gel for Pain Relief During Colposcopic Directed Cervical Biopsy
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ORIGINAL ARTICLE
Comparison of Lignocaine Spray Versus Lignocaine Gel for Pain Relief During Colposcopic Directed Cervical Biopsy Vijay Zutshi1 • Vaishnavi Seshan1
•
Amit Yadav2
Received: 2 August 2020 / Accepted: 12 October 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Objective The aim of the study was to compare the degree of pain experienced by the patient during colposcopic directed cervical biopsy with the use of topical lignocaine solution and topical lignocaine gel. Materials and Methods A prospective interventional randomized comparative study was conducted on 132 women who underwent colposcopic directed cervical biopsy. The participants were randomly assigned to either of the two groups—2% lignocaine gel or the 2% lignocaine solution. The pain experienced by patient was rated according to the visual analogue scale. Results A total of 132 women were included in the study: 65 in the lignocaine solution and 67 in the lignocaine gel group. Age, parity, age at menarche and at first child birth were similar in both the groups. The mean pain score with lignocaine solution was 3.58 ± 1.58, the maximum pain felt was 8 and the minimum pain felt was 1, whereas, with lignocaine gel, the mean pain score was 1.95 ± 0.96, the maximum pain felt was 5 and the minimum pain felt was 1. The difference in the pain was statistically significant with a p value of \ 0.001. Conclusion The use of lignocaine gel was found to reduce pain during colposcopic directed cervical punch biopsy as compared to lignocaine solution. Keywords Cervical biopsy Colposcopy Pain relief Local anesthesia Lignocaine solution Lignocaine gel
Introduction Traditionally, cervical biopsy is performed without the use of any local pain relief as the effect of anesthetic drugs over the visceral innervation of the cervix is questionable. However, it has been noted that a certain degree of discomfort is felt by the patient which is variable. Various pharmacological agents, nonpharmacological methods and & Vaishnavi Seshan [email protected] Vijay Zutshi [email protected] Amit Yadav [email protected] 1
Department of Gynaecology and Obstetrics, Vardhmaan Mahavir Medical College and Safdarjung Hospital, New Delhi, India
2
Department of Pathology, Vardhmaan Mahavir Medical College and Safdarjung Hospital, New Delhi, India
combination of pharmacological and nonpharmacological methods have been assessed for pain relief during colposcopic directed biopsy. Local anesthetics are commonly used to induce local insensitivity to pain which acts by blocking sodium channels and prevents further transmission of pain [1]. Lignocaine is an amide-linked surface anesthetic agent that has been widely used as it is stable, cheap and effective, especially over mucosal surfaces [2]. Various studies have been done to investigate the use of local anesthetic agents by different routes, either alone or in combination with other agents [3–12]. The results of the aforementioned studies are equivocal and conflicting, and no consensu
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