The efficacy of topical benzocaine gel in providing anesthesia prior to cervical biopsy and endocervical curettage

Daron Gale Ferris, Diane M. Harper, Brittain Callahan, Tim Robinson, Mark S. Litaker, Mark Messing, Laverne Mensah

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives. Our goal was to determine the effectiveness of topical 20% benzocaine gel in providing anesthesia prior to cervical biopsy and endocervical curettage (ECC) and to identify specific patient characteristics that would predict which patients would be more likely to benefit from the application of benzocaine gel before cervical procedures. Materials and Methods. Women requiring cervical biopsy and ECC completed a questionnaire that obtained demographical and pertinent gynecological information, perceived pain thresholds, and anxiety levels prior to the cervical biopsy procedures. Either benzocaine gel or a placebo was applied to the ectocervix and endocervical canal in a double-blinded fashion. After each procedure, subjects reported the type, intensity, character, and duration of the sensation via visual analog scales (VAS) (0 = no sensation, 100 = maximum sensation). Results. No difference was noted in the mean VAS scores reported by the placebo and benzocaine cohorts for the sensation felt at the time of cervical biopsy (30.1 SD ± 28.2 and 35.3 SD ± 24.3, respectively; p = .33). No significant difference in mean VAS scores was noted after ECC by the placebo cohort (53.0 SD ± 26.8) and the benzocaine cohort (41.0 SD ± 28.2; p = .09). Pain experienced with prior Papanicolaou (Pap) smears correlated significantly with the level of sensation noted during cervical biopsy (r = 0.395; p = .0001). The mean VAS scores for sensation experienced during cervical biopsy also were significantly greater among women who reported a history of dyspareunia (42.2 vs 27.7; p = .0059) and who reported a history of painful pelvic examinations (45.0 vs 29.8; p = .0125) than among women who did not report these painful experiences. Conclusions. Topical benzocaine gel was ineffective in reducing discomfort reported on cervical biopsy and ECC as compared with a placebo. Biopsy instrument sharpness may be a critically important factor that determines invoked pain. Discomfort associated with prior Pap smears, history of dyspareunia, and history of painful pelvic examinations correlated significantly with a greater perceived biopsy sensation. Prebiopsy recognition of these indicators may help clinicians to determine which women may be more likely to experience greater pain with cervical biopsy and enable them to intervene with other pain prevention measures.

Original languageEnglish (US)
Pages (from-to)221-227
Number of pages7
JournalJournal of Lower Genital Tract Disease
Volume1
Issue number4
DOIs
StatePublished - Jan 1 1997

Fingerprint

Benzocaine
Curettage
Anesthesia
Gels
Biopsy
Visual Analog Scale
Placebos
Dyspareunia
Papanicolaou Test
Gynecological Examination
Pain
Pain Threshold
Neck Pain
Anxiety

Keywords

  • Anesthesia
  • Cervical biopsy
  • Colposcopy
  • Endocervical curettage

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

The efficacy of topical benzocaine gel in providing anesthesia prior to cervical biopsy and endocervical curettage. / Ferris, Daron Gale; Harper, Diane M.; Callahan, Brittain; Robinson, Tim; Litaker, Mark S.; Messing, Mark; Mensah, Laverne.

In: Journal of Lower Genital Tract Disease, Vol. 1, No. 4, 01.01.1997, p. 221-227.

Research output: Contribution to journalArticle

Ferris, Daron Gale ; Harper, Diane M. ; Callahan, Brittain ; Robinson, Tim ; Litaker, Mark S. ; Messing, Mark ; Mensah, Laverne. / The efficacy of topical benzocaine gel in providing anesthesia prior to cervical biopsy and endocervical curettage. In: Journal of Lower Genital Tract Disease. 1997 ; Vol. 1, No. 4. pp. 221-227.
@article{c381c0c7745047b596f7cd0a62f858e0,
title = "The efficacy of topical benzocaine gel in providing anesthesia prior to cervical biopsy and endocervical curettage",
abstract = "Objectives. Our goal was to determine the effectiveness of topical 20{\%} benzocaine gel in providing anesthesia prior to cervical biopsy and endocervical curettage (ECC) and to identify specific patient characteristics that would predict which patients would be more likely to benefit from the application of benzocaine gel before cervical procedures. Materials and Methods. Women requiring cervical biopsy and ECC completed a questionnaire that obtained demographical and pertinent gynecological information, perceived pain thresholds, and anxiety levels prior to the cervical biopsy procedures. Either benzocaine gel or a placebo was applied to the ectocervix and endocervical canal in a double-blinded fashion. After each procedure, subjects reported the type, intensity, character, and duration of the sensation via visual analog scales (VAS) (0 = no sensation, 100 = maximum sensation). Results. No difference was noted in the mean VAS scores reported by the placebo and benzocaine cohorts for the sensation felt at the time of cervical biopsy (30.1 SD ± 28.2 and 35.3 SD ± 24.3, respectively; p = .33). No significant difference in mean VAS scores was noted after ECC by the placebo cohort (53.0 SD ± 26.8) and the benzocaine cohort (41.0 SD ± 28.2; p = .09). Pain experienced with prior Papanicolaou (Pap) smears correlated significantly with the level of sensation noted during cervical biopsy (r = 0.395; p = .0001). The mean VAS scores for sensation experienced during cervical biopsy also were significantly greater among women who reported a history of dyspareunia (42.2 vs 27.7; p = .0059) and who reported a history of painful pelvic examinations (45.0 vs 29.8; p = .0125) than among women who did not report these painful experiences. Conclusions. Topical benzocaine gel was ineffective in reducing discomfort reported on cervical biopsy and ECC as compared with a placebo. Biopsy instrument sharpness may be a critically important factor that determines invoked pain. Discomfort associated with prior Pap smears, history of dyspareunia, and history of painful pelvic examinations correlated significantly with a greater perceived biopsy sensation. Prebiopsy recognition of these indicators may help clinicians to determine which women may be more likely to experience greater pain with cervical biopsy and enable them to intervene with other pain prevention measures.",
keywords = "Anesthesia, Cervical biopsy, Colposcopy, Endocervical curettage",
author = "Ferris, {Daron Gale} and Harper, {Diane M.} and Brittain Callahan and Tim Robinson and Litaker, {Mark S.} and Mark Messing and Laverne Mensah",
year = "1997",
month = "1",
day = "1",
doi = "10.1097/00128360-199710000-00005",
language = "English (US)",
volume = "1",
pages = "221--227",
journal = "Journal of Lower Genital Tract Disease",
issn = "1089-2591",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - The efficacy of topical benzocaine gel in providing anesthesia prior to cervical biopsy and endocervical curettage

AU - Ferris, Daron Gale

AU - Harper, Diane M.

AU - Callahan, Brittain

AU - Robinson, Tim

AU - Litaker, Mark S.

AU - Messing, Mark

AU - Mensah, Laverne

PY - 1997/1/1

Y1 - 1997/1/1

N2 - Objectives. Our goal was to determine the effectiveness of topical 20% benzocaine gel in providing anesthesia prior to cervical biopsy and endocervical curettage (ECC) and to identify specific patient characteristics that would predict which patients would be more likely to benefit from the application of benzocaine gel before cervical procedures. Materials and Methods. Women requiring cervical biopsy and ECC completed a questionnaire that obtained demographical and pertinent gynecological information, perceived pain thresholds, and anxiety levels prior to the cervical biopsy procedures. Either benzocaine gel or a placebo was applied to the ectocervix and endocervical canal in a double-blinded fashion. After each procedure, subjects reported the type, intensity, character, and duration of the sensation via visual analog scales (VAS) (0 = no sensation, 100 = maximum sensation). Results. No difference was noted in the mean VAS scores reported by the placebo and benzocaine cohorts for the sensation felt at the time of cervical biopsy (30.1 SD ± 28.2 and 35.3 SD ± 24.3, respectively; p = .33). No significant difference in mean VAS scores was noted after ECC by the placebo cohort (53.0 SD ± 26.8) and the benzocaine cohort (41.0 SD ± 28.2; p = .09). Pain experienced with prior Papanicolaou (Pap) smears correlated significantly with the level of sensation noted during cervical biopsy (r = 0.395; p = .0001). The mean VAS scores for sensation experienced during cervical biopsy also were significantly greater among women who reported a history of dyspareunia (42.2 vs 27.7; p = .0059) and who reported a history of painful pelvic examinations (45.0 vs 29.8; p = .0125) than among women who did not report these painful experiences. Conclusions. Topical benzocaine gel was ineffective in reducing discomfort reported on cervical biopsy and ECC as compared with a placebo. Biopsy instrument sharpness may be a critically important factor that determines invoked pain. Discomfort associated with prior Pap smears, history of dyspareunia, and history of painful pelvic examinations correlated significantly with a greater perceived biopsy sensation. Prebiopsy recognition of these indicators may help clinicians to determine which women may be more likely to experience greater pain with cervical biopsy and enable them to intervene with other pain prevention measures.

AB - Objectives. Our goal was to determine the effectiveness of topical 20% benzocaine gel in providing anesthesia prior to cervical biopsy and endocervical curettage (ECC) and to identify specific patient characteristics that would predict which patients would be more likely to benefit from the application of benzocaine gel before cervical procedures. Materials and Methods. Women requiring cervical biopsy and ECC completed a questionnaire that obtained demographical and pertinent gynecological information, perceived pain thresholds, and anxiety levels prior to the cervical biopsy procedures. Either benzocaine gel or a placebo was applied to the ectocervix and endocervical canal in a double-blinded fashion. After each procedure, subjects reported the type, intensity, character, and duration of the sensation via visual analog scales (VAS) (0 = no sensation, 100 = maximum sensation). Results. No difference was noted in the mean VAS scores reported by the placebo and benzocaine cohorts for the sensation felt at the time of cervical biopsy (30.1 SD ± 28.2 and 35.3 SD ± 24.3, respectively; p = .33). No significant difference in mean VAS scores was noted after ECC by the placebo cohort (53.0 SD ± 26.8) and the benzocaine cohort (41.0 SD ± 28.2; p = .09). Pain experienced with prior Papanicolaou (Pap) smears correlated significantly with the level of sensation noted during cervical biopsy (r = 0.395; p = .0001). The mean VAS scores for sensation experienced during cervical biopsy also were significantly greater among women who reported a history of dyspareunia (42.2 vs 27.7; p = .0059) and who reported a history of painful pelvic examinations (45.0 vs 29.8; p = .0125) than among women who did not report these painful experiences. Conclusions. Topical benzocaine gel was ineffective in reducing discomfort reported on cervical biopsy and ECC as compared with a placebo. Biopsy instrument sharpness may be a critically important factor that determines invoked pain. Discomfort associated with prior Pap smears, history of dyspareunia, and history of painful pelvic examinations correlated significantly with a greater perceived biopsy sensation. Prebiopsy recognition of these indicators may help clinicians to determine which women may be more likely to experience greater pain with cervical biopsy and enable them to intervene with other pain prevention measures.

KW - Anesthesia

KW - Cervical biopsy

KW - Colposcopy

KW - Endocervical curettage

UR - http://www.scopus.com/inward/record.url?scp=0042128896&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0042128896&partnerID=8YFLogxK

U2 - 10.1097/00128360-199710000-00005

DO - 10.1097/00128360-199710000-00005

M3 - Article

VL - 1

SP - 221

EP - 227

JO - Journal of Lower Genital Tract Disease

JF - Journal of Lower Genital Tract Disease

SN - 1089-2591

IS - 4

ER -