As per a randomised study published in the 'Journal of Obstetrics and Gynaecology', Local lidocaine spray (LS) has superiority concerning pain relief during the colposcopic biopsy procedure along with no adverse reactions.  Different techniques have been proposed to relieve the painful- colposcopic-guided cervical biopsy. According to studies, forced coughing is a good and easy method for relieving pain but has some disadvantages. Similarly, Local LS is another option for the same.  Erbil Karaman et al. compared the effectiveness of local LS to forced coughing (FC) for pain relief during colposcopically guided cervical biopsies (CGBs). The patients with abnormal cervical cytologic results requiring a colposcopic biopsy procedure were included in this study.  They were randomly designated to either the 10% LS or the FC groups before the biopsy procedure. Primary outcome comprised of pain assessed using a 10 cm visual analogue scale at the different steps during the process.  A total of 86 patients (44 using LS and 42 using FC) had CGBs. In both the groups, BMI, age, parity, history of the previous curettage and vaginal delivery, smoking status and the number of biopsies were similar. Mean ± SD pain scores following cervical biopsy were 3.25 ± 1.4 and 4.4 ± 1.3 in the LS and FC groups, respectively. The time for operation was longer in the LS as compared to the FC group. There were no complication or adverse effect in both the groups.  "The evidence from different studies depicted some controversial results concerning pain relief methods during the colposcopic biopsy procedure.

Local LS can be used in this method in routine clinical practice", noted the study authors. Although, they felt the need for further studies with larger samples and comparison of different methods.