Efficacy and safety of tramadol in pain relief during diagnostic outpatient hysteroscopy: systematic review and meta-analysis of randomized controlled trials

Mattar, Omar Mohamed; Abdalla, Ahmed; Shehata, Mohamed; Ali, Ahmed Said; Sinokrot, Muhammed; Abdelazeim, Bassant; Taher, Ayman; Samy, Ahmed; Mahmoud, Mostafa; Abbas, Ahmed M.

doi:10.1016/j.fertnstert.2018.10.026

Cited by 15 publications

(7 citation statements)

References 18 publications

(28 reference statements)

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“…A major impetus for this review was the review two years ago performed by Mattar et al ( 17 ) in 2019 that first showed an improvement in pain scores with the use of tramadol during OH. This review also found that the use of tramadol resulted in no significant adverse effects.…”

Section: Discussionmentioning

confidence: 99%

“…Since the last major meta-analysis of the use of tramadol in OH ( 17 ) , our authors observed the publication of two major randomized controlled trials (RCTs) on this same topic ( 18 , 19 ) . As a result, in response to the new relative wealth of data, we aimed to systematically review all available data concerning the efficacy and safety of tramadol in relieving the pain of OH.…”

Section: Introductionmentioning

confidence: 99%

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Systematic review of the safety and efficacy of tramadol during office hysteroscopy

Maarouf¹,

Marchand²,

Ware³

et al. 2021

tjod

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Office hysteroscopy (OH) is a common procedure in gynecology. Pain is the most frequently reported problem in OH. In this study, we aimed to investigate the role of tramadol administration in relieving pain in women undergoing OH. We searched PubMed, the Cochrane Library, ClinicalTrials.gov, MEDLINE, Scopus, and Web of Science databases for relevant clinical trials based on our search terms. We included randomized controlled trials and included all published trials in all six searched databases from their inception until February 28 th 2021. We included pain as the primary outcome, and the incidence of adverse events of tramadol as secondary outcomes. We performed the analysis of continuous data using mean difference (MD) and dichotomous data using risk ratio (RR). We found that tramadol led to significantly less pain during the actual procedure [MD=-1.27, 95% confidence interval (CI): (-1.66, -0.88); p<0.001], immediately after the procedure [MD=-1.03, 95% CI: (-1.40, -0.67); p<0.001], and 30 minutes after the procedure [MD=-0.74, 95% CI: (-1.06, -0.41); p<0.001]. Regarding safety endpoints, no significant difference was noted for dizziness [RR=1.88, 95% CI: (0.79, 4.47); p=0.16] or vomiting [RR=1.80, 95% CI: (0.40, 8.18); p=0.45]. Based on the available data, we conclude that tramadol administration seems to be both effective and safe for patients undergoing office hysteroscopy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Systematic review of the safety and efficacy of tramadol during office hysteroscopy

Maarouf¹,

Marchand²,

Ware³

et al. 2021

tjod

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“…In this analysis was demonstrated that opioids given 40 to 60 minutes before hysteroscopy, reduce the pain during and after operation [39]. The administration of opioid analgesics is currently not recommended for outpatients hysteroscopy due to the possibility of several side effects [40]. The use of antianxiety drugs does not offer pain reduction [41].…”

Section: Pain Complaintsmentioning

confidence: 99%

An Overview of Outpatient Hysteroscopy

Ignaszak-Kaus¹,

Chmaj-Wierzchowska²,

Nowak³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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Objective: Hysteroscopic procedures are minimally invasive procedures that enable to assess the uterine cavity (diagnostic hysteroscopy) and to treat intrauterine lesions (operative hysteroscopy). In recent years have witnessed a steady increase in the number of procedures performed via minimally invasive surgery (MIS) including hysteroscopies. Most outpatient hysteroscopies are painless, without complications, and not only allow to diagnose but also treat several intrauterine pathologies. Vaginoscopy hysteroscopy without using speculum, tenaculum and other potentially painful instrumentation should become the default method for outpatient hysteroscopy. This 'no-touch' technique is faster in contrary to standard hysteroscopy and is associated with less pain. Mechanism: A wide range of feasible procedures, constantly improved endoscopic equipment and tools, improving the technical conditions of the procedure, as well as short hospitalization time and a quick recovery period, are just some of the benefits of hysteroscopic surgeries. Findings in Brief: Performing hysteroscopy in an outpatient setting without general anesthesia addictionally reduces treatment cost and avoid of possible complications of general anesthesia. Conclusions: Performing hysteroscopy in an outpatient setting without general anesthesia (with the patient's consciousness preserved during the surgery) reduces treatment cost and shortens the duration of hospitalization and convalescence, thus increasing patient satisfaction with care.

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“…Opioids reduce pain during and after the procedure, but caution is advised due to possible adverse effects [4,44].…”

Section: Elimination Of Perioperative Painmentioning

confidence: 99%

Polish Society of Gynecologists and Obstetricians Guidelines for the application of hysteroscopy in gynecology

et al. 2019

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This guideline presents current management recommendations which may be modified and altered in justifiable cases, after careful analysis of a given clinical case, which in the future might constitute grounds for modification and updating. OBJECTIVESThe objective of this guideline is to present up-to-date knowledge about the application of hysteroscopy in gynecology, based on the experience of the authors and reliable sources from the literature.

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Efficacy and safety of tramadol in pain relief during diagnostic outpatient hysteroscopy: systematic review and meta-analysis of randomized controlled trials

Cited by 15 publications

References 18 publications

Systematic review of the safety and efficacy of tramadol during office hysteroscopy

Systematic review of the safety and efficacy of tramadol during office hysteroscopy

An Overview of Outpatient Hysteroscopy

Polish Society of Gynecologists and Obstetricians Guidelines for the application of hysteroscopy in gynecology

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