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Marco Zaccaria: Intrauterine Lidocaine for Pain Management During Outpatient Hysteroscopy
Marco Zaccaria/LinkedIn
Jun 16, 2026, 15:43

Marco Zaccaria: Intrauterine Lidocaine for Pain Management During Outpatient Hysteroscopy

Marco Zaccaria, Global Product Manager at ESGE European Society Gynecology Endoscopy, shared a post on LinkedIn:

“Intrauterine lidocaine instillation is a safe and effective technique for reducing pain during certain specific phases of outpatient hysteroscopy, although it has specific time and procedural limitations

Pain management using intrauterine lidocaine varies considerably depending on the stage of the examination:

  • Pain reduction during insertion: the primary efficacy is observed as the hysteroscope passes through the cervical canal, where it significantly reduces the pain score (VAS scale) compared to placebo
  • Early post-procedural benefit: it ensures a reduction in discomfort during the first 10 minutes following the end of the procedure
  • Limitations regarding distension and biopsy: the analgesic effect is limited or absent for deep pain caused by uterine distension with fluids/gas or during an endometrial biopsy

What about protocol and standard dosage?

Typically, 5 mL of 2% lidocaine (equivalent to 100 mg) is used and as regards waiting time, the solution is slowly injected into the uterine cavity and allowed to take effect for approximately 3 minutes before beginning the hysteroscopy, often while keeping the patient in the Trendelenburg position.”

Marco Zaccaria: Intrauterine Lidocaine for Pain Management During Outpatient Hysteroscopy

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analgesic effect cervical canal endometrial biopsy Fertility Fertility Nres Intrauterine lidocaine instillation Marco Zaccaria outpatient hysteroscopy pain score (VAS scale) reproductive health Reproductive Medicine Trendelenburg position Uterine cavity uterine distension
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