Ineffectiveness of topical benzocaine spray during colposcopy

Colposcopic evaluation can cause patients to experience pain and anxiety. This study investigated the use of benzocaine spray, a topical anesthetic, and its effects on pain and anxiety associated with colposcopy and colposcopic biopsy.

The study was a double-blind, placebo-controlled trial of the effectiveness of benzocaine spray applied to the cervix immediately before colposcopic examination, cervical biopsy, or endocervical curettage in patients of a family practice center. Prior to the gynecologic procedure the patient's cervix was sprayed with either benzocaine spray or matching placebo spray. After waiting at least 30 seconds the clinician started the procedure. Pain and anxiety, measured on 10-cm visual analog scales, were determined at the following times: (1) before the start of the gynecologic examination; (2) immediately before using the spray; (3) immediately after using the spray; and, (4) after the procedure was completed.

Of 58 consecutive patients who underwent colposcopy, 36 patients were eligible for the trial and were evaluated. Participants were similar to patients not participating with regard to race, gravidity, and parity. Statistical analysis found significant differences in both pain and anxiety scores over time (repeated measures multivariate ANOVA, P < .0001), but no difference between the use of active drug and placebo. Pain scores increased significantly after application of either benzocaine or placebo spray before the start of the procedure (average increase 1.3 cm, P < .0001).

Benzocaine, in a spray vehicle, confers no benefit when used to decrease pain and anxiety in women undergoing colposcopic procedures.