Background: A variety of anesthetic and analgesic techniques have been used for uterine aspiration, and most clinicians use a paracervical block with or without additional analgesia. We intended to evaluate whether the addition of 10% lidocaine spray to a paracervical block decreases pain during cervical dilation and uterine aspiration. Study Design: Seventy-seven patients were divided into two groups: paracervical blocks (PCB) (n=30) and PCB plus 10% lidocaine spray (n=47). Anticipated and overall perceived pain scores were measured with a standard Visual Analog Scale (VAS). Results: Anticipated pain VAS scores of two groups were similar, however overall perceived pain VAS scores demonstrated a significant difference. PCB with Lidocaine only group had 6.56±1.43 cm mean VAS score, whereas lidocaine plus lidocaine spray group had 2.35±1.39 cm, the difference being statistically significant (p<.01). Conclusion: We found that 10% lidocaine spray safely decreases perceived pain during first-trimester surgical abortion, when used in addition to PCB with lidocaine HCl. © 2011 Elsevier Inc.