By Megan Rauscher

NEW YORK (Reuters Health) - For women undergoing a biopsy of the cervix, forced coughing is as good as a local lidocaine injection for reducing the discomfort of the procedure, a study indicates.

"Furthermore, forced coughing is a time saver and cuts down the costs associated with the biopsy," the study team notes in the American Journal of Obstetrics and Gynecology.

In comments to Reuters Health, first author Dr. Bernd C. Schmid said, "Experience told us that forced coughing is a good pain relief method for minor interventions. This is the first article successfully describing this method during cervical biopsy and thereby putting evidence to this technique."

In the study, conducted at the Medical University of Vienna in Austria, 68 women undergoing cervical punch biopsies for assessment of abnormal Pap smears were randomly assigned to get a cervical injection of lidocaine or to produce forced coughing at the moment of biopsy for pain relief.

The study team found that the overall pain score on a 0-10 centimeter scale was 2.3 cm with lidocaine vs. 3.0 with coughing, which was not a statistically significant difference from a statistical standpoint.

"However, when local anesthesia was applied, the examination was significantly prolonged by a median of 2.11 minutes," the researchers report.

Schmid and colleagues conclude that pain associated with cervical biopsies "can be reduced by forced coughing to the same extent but in a cheaper and faster way than by injection of a local anesthetic."

SOURCE: American Journal of Obstetrics and Gynecology, December 2008.

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