Prevalence and intensity of pain during diagnostic hysteroscopy in women attending an infertility clinic: analysis of 489 cases

Pegoraro, A.; Santos, Marcelo Ettruri; Takamori, Jean Tetsuo; Carvalho, Waldemar de Almeida Pereira de; Oliveira, Renato de; Barbosa, Caio Parente; Nimwegen, Angela Van

doi:10.31744/einstein_journal/2020ao4916

Cited by 6 publications

(8 citation statements)

References 31 publications

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“…The mean STAI-S and STAI-T were above 40, which is higher than the score of the Brazilian female population (mean: 35.7) and suggests a moderate level of anxiety before the examination, similar to other studies. It has been suggested that scores of 39 to 55 are indicative of clinically significant anxiety 7,12,20,22 .…”

Section: Discussionmentioning

confidence: 99%

Pain and anxiety in office histeroscopy

Rolim

Morais

Nogueira

et al. 2020

Rev. Assoc. Med. Bras.

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SUMMARY BACKGROUND: Anxiety is almost always present before medical interventions and may play a role in pain perception. We aim to evaluate factors associated with pain intensity reported by patients submitted to Office Hysteroscopy (OH). METHODS: Cross-sectional observational study, with data from April to November 2015. It included patients attended at the Assis Chateaubriand Maternity School (MEAC/UFC) with an indication of office hysteroscopy. Before the examination, the patients answered a validated questionnaire about anxiety (STAI). After the examination, women answered the Visual Analogue Scale (VAS). The data were analyzed using the Statistical Package for the Social Sciences (SPSS) 15.0, with Spearman correlation, Mann-Whitney U-test, and analyses of variance. RESULTS: 252 patients were included, with a mean age of 45.7 years, of whom 29% were postmenopausal (mean pain 5.5) and 71% were in menacme (mean pain 5.1) (p = 0.258). The anxiety trait and state showed a significant influence on the pain scale (p <0.001 and p=0.001), but age or endometrial sample did not. 27% of the patients were nulliparous. Less pain was associated with the number (p=0.01) and vaginal (p=0.005) of deliveries. The main indication for the procedure was abnormal uterine bleeding (54.4%). CONCLUSION: OH may be associated with moderate but tolerable discomfort. There was a significant correlation between higher scores on the pain scale and anxiety. There was evidence of reduced pain with parity and type of delivery, but not with reproductive age or endometrial biopsy.

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Section: Discussionmentioning

confidence: 99%

Pain and anxiety in office histeroscopy

Rolim

Morais

Nogueira

et al. 2020

Rev. Assoc. Med. Bras.

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“…Music has been found to decrease procedurerelated pain in some studies [7] but not in others [8]. Surgeon experience is probably also important, although not well studied [9]. Opioids have not been shown to reduce pain during procedure and have been associated with significant adverse reactions [10].…”

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confidence: 99%

Addition of Lidocaine to the Distension Medium in Hysteroscopy Decreases Pain during the Procedure–A Randomized Double-blind, Placebo-controlled Trial

Barel

Preuss

Stolovitch

et al. 2021

Journal of Minimally Invasive Gynecology

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To evaluate the effect of adding a local anesthetic to the distension medium in office diagnostic hysteroscopy using the vaginoscopic approach on pain during the procedure. Secondary aims included documenting side effects, patient satisfaction, and the time needed to complete the procedure. Design: Randomized double-blind placebo-controlled study. Setting: University-affiliated hospital; office hysteroscopy clinic. Patients: Total of 100 patients who underwent office hysteroscopies divided in half with 50 in the intervention group and 50 in the control group. Interventions: Ten mL of lidocaine 2% added to 1000 mL of saline solution that was used as the distension medium for hysteroscopy in the study group vs 1000 mL of saline alone in the control group. Measurements and Main Results: A significant difference was found in the increment of pain as measured by visual analog scale after the hysteroscopy between the 2 groups. Patients receiving lidocaine had an average rise of 1.9 in the visual analog scale score after the procedure compared with 2.9 in the control group (p = .033). There was also a nonsignificant trend for shorter duration of hysteroscopy in the intervention group compared with the control group (180.1 vs 222.1 seconds, p = .08). Patients' satisfaction was high in both groups (98% for the study group and 92% for the control group). Success rates were also similar between the 2 groups at approximately 95%. No side effects were recorded in either group. Conclusion:The addition of local anesthetic to the distension medium in office hysteroscopy produces significant reduction in pain during the procedure without adding time to the procedure and without side effects.

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“…12 Anxiety is linked to central and peripheral neurobiological mechanisms that can influence pain perception, contributing to its increase and influencing tolerance during the procedure. 13,14 Studies show that a higher trait of anxiety exacerbates pain. Anxiety causes activation of the sympathetic nervous system, which transmits a neural signal via the hypothalamus to stimulate the preganglionic release of the neurotransmitter, acetylcholine, leading to further release of catecholamines and, consequently, mechanical hyperalgesia mediated by adrenergic receptors and sensitization of nociceptor neurons.…”

Section: Discussionmentioning

confidence: 99%

Nurse support for pain and anxiety control in women undergoing diagnostic hysteroscopy: a randomized clinical trial

2023

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Objective The aim of the study is to evaluate the effectiveness of nurse support for controlling pain and anxiety in women undergoing diagnostic hysteroscopy. Methods This randomized clinical trial included 192 women who underwent diagnostic hysteroscopy at an academic hospital. Women were divided into two groups: those who received nurse support (n = 95) as the intervention group and those who did not (n = 97) as the control group. Results The mean age of women was 54.24 ± 13.91 years and 53.47 ± 13.24 years (P = 0.670) in the intervention and control groups, respectively. There were no differences in clinical and sociodemographic variables between the groups. The mean pain score during examination was 6.62 ± 2.60 and 7.05 ± 2.30 (P = 0.327) for the intervention and control groups, respectively. Most women in both groups were satisfied with the examination (P = 0.777). There was a significant reduction in systolic blood pressure and heart rate during the examination in the intervention group (P = 0.029 and P < 0.001, respectively) and an increase in anxiety scores in the control group (P = 0.009). Conclusions There was no reduction in pain scores during hysteroscopy with nurse support. However, the control group showed an increase in anxiety scores after the hysteroscopy.

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Prevalence and intensity of pain during diagnostic hysteroscopy in women attending an infertility clinic: analysis of 489 cases

Cited by 6 publications

References 31 publications

Pain and anxiety in office histeroscopy

Pain and anxiety in office histeroscopy

Addition of Lidocaine to the Distension Medium in Hysteroscopy Decreases Pain during the Procedure–A Randomized Double-blind, Placebo-controlled Trial

Nurse support for pain and anxiety control in women undergoing diagnostic hysteroscopy: a randomized clinical trial

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