Patient Discomfort
If the EMB procedure is too painful for your patient, consider a combination of the available anesthetic options or refer to gynecology (for the procedure to be performed in the operating room under general anesthesia or conscious sedation with regional anesthesia).
Anesthetic options include:
Ibuprofen 600 to 800mg or other NSAID, given at least one hour before the procedure.
Intrauterine installation of 5cc, 2% xylocaine through an 18g angiocath, introduced through the cervical os.
Paracervical block or cervical injection of xylocaine could theoretically be used, but increase the risk of complication with little potential benefit.
Oral narcotics or benzodiazepines can be used if the patient has already signed the consent form and has someone to accompany them.