Lidocaine spray, IUL, PCB, and oral NSAIDs were found to be effective pain control options during EMB. Vulvar biopsy is largely unstudied, but the procedure induces significant changes in VAS scores as compared with patient baselines. For colposcopy and LEEP, local anesthetic with injection of lidocaine is superior to nonpharmacologic interventions such as music. Lidocaine spray remains a better alternative than no pain intervention. Patient preference, while variable, is an important factor to consider when choosing an anesthetic intervention.
Hillard et al. (2026) studied this question.
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