I’ve found this an interesting topic - and an important one - for some time now.
Given the stories I’ve read about the awful experiences some women have with… Colposcopy with cervical biopsies… Endometrial Biopsies… IUD insertion… and others, one has to wonder, why is it like this?
So I’ve researched it. I’ve come across numerous studies on PubMed where they try to prove that local anesthetic makes a clear improvement, but … it rarely does. The statistics in the blind study usually end up showing that even when it helps some women, other women find the injections more painful. Or that they find the injections on the cervix painful AND the procedure still hurts just as much, or almost as much (for the paracervixal block).
I can’t even imagine how frustrating and scary this must be for most women, and how much it generally sucks. But for the life of me, I’m not sure what I would say should be changed….
If the local anesthetic doesn’t help overly much then should more thorough anesthesia, like general anesthesia, be used? Is twilight anesthesia, like what is used for colonoscopies, something that should be used? I do know that the local works for *some* women - but the inconsistency of the results would seem to imply it should be a choice offered by the provider and selected by the patient. “This may work, but it doesn’t work for all women - it’s your choice whether you want to try it.” Especially for those women with bad experiences, I’d think it would be an easy choice.
What say you medical geeks? Wherefore art the state of pain control for gynecology these days?