Lidocaine spray effective anesthesia in LEEP

(HealthDay)—For patients undergoing a loop electrosurgical excision procedure (LEEP), a lidocaine spray is safe and effective for local anesthesia, according to a study published online Aug. 5 in Obstetrics & Gynecology.

Asama Vanichtantikul, M.D., and Kittipat Charoenkwan, M.D., from Chiang Mai University in Thailand, randomly assigned women undergoing LEEP for cervical intraepithelial neoplasia to receive anesthesia either by 1.8 mL (36 mg) of 2 percent lidocaine with 1:100,000 epinephrine injected submucosally using a pressure syringe injector with a 27-gauge needle tip at 3, 6, 9, and 12 o'clock locations of the ectocervix (51 patients) or local anesthesia with four puffs (40 mg) of 10 percent lidocaine spray applied thoroughly to the ectocervix (50 patients). A 10-cm visual analog scale was utilized at different points during the procedure (baseline, post-anesthesia, excision, and 30 minutes post-excision) to rate pain.

The researchers found that the two groups had comparable scores for baseline pain scores, the excision pain scores, the difference between the excision and the baseline pain scores, and the post-excision pain scores. The median post-anesthesia pain score and the median difference of the post-anesthesia score from baseline were significantly higher in the injection group compared to the spray group.

"Lidocaine spray is an effective and practical alternative measure for reducing pain associated with electrical excision of the cervix during LEEP," the authors write.