Is Forced Coughing Effective in Reducing Pain During Cervical Biopsy?

Abstract

Our objective was to compare potential analgesic effect of forced coughing (FC) technique versus local anesthetics (LA) or placebo during cervical biopsy. We systematically searched five electronic databases from inception till March 2021; Scopus, PubMed, Web of Science, Cochrane Library, Google Scholar. The data was extracted from six RCTs and analyzed them using Review Manager Software. During cervical biopsy, the overall effect estimate favored LA over FC group (MD =1.06; 95% CI [0.58 to 1.54]; p < 0.0001). On the other hand, when compared to no pain management pooled data were comparable between the two groups (MD = -1.2; 95% CI [-3.35 to 0.94]; p = 0.27). Procedure duration was significantly longer in LA than FC group (MD = -1.94; 95% CI [-2.47 to - 1.41]; p < 0.00001). FC and LA seemed to useful pain-lowering modalities during the cervical biopsy according to settings and availability. Further studies are recommended.
 Keywords: Cervical Biopsy; Colposcopy; Forced Coughing; Pain.