Is Forced Coughing Effective in Reducing Pain During Cervical Biopsy? A systematic review and meta-analysis

Abstract

This review aimed to compare the potential analgesic effect of forced coughing (FC) with that of local anaesthetics (LA) or placebo during cervical biopsy. A total of 5 electronic databases—Scopus, PubMed, Web of Science, Cochrane Library and Google Scholar—were systematically searched from inception till March 2021. Data were extracted from 6 randomised controlled trials and analysed. During cervical biopsy, the overall effect favoured LA over FC (mean difference [MD] = 1.06, 95% confidence interval [CI]: 0.58 to 1.54; P <0.0001). 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 the LA group than in the FC group (MD = −1.94, 95% CI: −2.47 to −1.41; P <0.00001). FC and LA are both useful pain-lowering modalities during cervical biopsy, depending on the setting and their availability.

Keywords: Biopsy; Colposcopy; Anesthesia; Pain.