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Cryosurgery is an effective treatment for squamous intraepithelial lesions, but causes pain and cramping regardless of the particular method of cryosurgery used. The purpose of our study was to determine how effective a four-quadrant cervical mucosal block is in reducing the pain and cramping of cryosurgery.Of the 112 women presenting for cryosurgery at the teaching clinics of the University of Missouri-Kansas City School of Medicine at Truman Medical Center-East between September 1995 and September 1996, 87 completed the study. The first 39 women were given the standard treatment of no block with the cryosurgery procedure. The subsequent 48 women were given a four-quadrant submucosal block of 1% lidocaine with 1:100,000 epinephrine 5 minutes before cryosurgery. The intensity of pain and cramping of each part of the procedure was measured on 100-mm visual analog scales.The pain and cramping of cryosurgery were significantly reduced (P <.05) with the mucosal block for all measured parts of the cryosurgery procedure, including pain of the first freeze (39 mm vs 12 mm), cramping of the first freeze (49 mm vs 13 mm), pain of the second freeze (24 mm vs 12 mm), cramping of the second freeze (32 mm vs 18 mm), pain of the total composite procedure (44 mm vs 28 mm), and cramping of the total composite procedure (51 mm vs 21 mm).A four-quadrant mucosal block effectively reduces the amount of pain and cramping associated with cryosurgery.