Aim: To examine the effect of lidocaine spray for reducing pain during endometrial aspiration biopsy by comparing it with placebo and no intervention.

Methods: Women undergoing endometrial aspiration biopsy from March 2017 to January 2018 were invited to participate. The participants were randomly assigned into three groups. In group 1 (lidocaine spray), eight puffs (80 mg, 10 mg/puff, 0.8 mL) of 10% lidocaine spray was applied thoroughly to the cervix, 3 min before starting the procedure. For group 2 (placebo spray), 0.8 mL of normal saline spray was applied to the cervix, 3 min before starting the procedure. For group 3 (no intervention), no anesthesia was given. The patients rated their pain according to a 10‐cm visual analog scale at different points including baseline, immediately after the procedure (biopsy pain), and 10 min after the procedure. The 10‐cm visual analog scale on satisfaction was also rated before hospital discharge. Comparison of continuous variables was made by using Kruskal–Wallis test. Chi squared test was used for comparison of categorical variables.

Results: Two hundred and forty patients (80 in each group) participated. The mean baseline, biopsy and postprocedural pain scores were not significantly different among the study groups. Similarly, the mean difference between the biopsy and the baseline pain scores were comparable among the groups. In addition, there was no difference on the satisfaction scores among the groups.

Conclusion: Lidocaine spray applied to the cervix is not effective for reducing pain associated with pipelle endometrial aspiration biopsy.