SAMPLE SIZE: The sample size calculation is based on the null hypothesis that the mean pain score will be the same in women treated with buffered lidocaine as in those treated with non-buffered placebo. The alternative hypothesis (two-sided) is that the mean pain score in women treated with buffered lidocaine will be different than those treated with non-buffered lidocaine. Assuming an alpha of 0.05, 80% power, and a standard deviation of 21-30 mm (based on a previous study measuring pain with tenaculum application and intracervical block), we will need to recruit 64 women per arm to be able to detect a 15 mm mean difference between groups on the 100 mm VAS. This difference is derived from a prior study showing the minimally clinically significant difference in acute pain on the VAS is 12 mm, with a 95% confidence interval range from 9 to 15 mm. Therefore, we plan to recruit a total of 128 patients, or 64 patients per arm.