Predictive factors for pain experienced at office fluid minihysteroscopy

Cicinelli, Ettore; Rossi, A. Cristina; Marinaccio, Marco; Matteo, Maria; Saliani, Nicola; Tinelli, Raffaele

doi:10.1016/j.jmig.2007.03.008

Cited by 44 publications

(38 citation statements)

References 11 publications

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“…Outpatient hysteroscopy has been used successfully for diagnostic purposes and for see-and-treat philosophy, as is evident from many papers on the subject -by Bettocchi et al, [15] Spiezio et al, [16] Papalampros et al [17] and Cicinelli et al [18,19] Hysteroscopy is a very useful modality in the diagnosis of varying grades of adhesions in genital tuberculosis, as has been seen in our experience. [20] In the present study, randomization was done in the 3 groups: group I receiving combination of oral drotaverine hydrochloride and mefenamic acid 1 hour before the procedure; group II receiving 10 mL of 1% lignocaine hydrochloride paracervically 5 minutes before the procedure; and group III receiving intravenous diazepam and pentazocine 10 minutes before the procedure.…”

Section: Discussionsupporting

confidence: 59%

Comparison of efficacy of oral drotaverine plus mefenamic acid with paracervical block and with intravenous sedation for pain relief during hysteroscopy and endometrial biopsy

Sharma¹,

Aruna²,

Kumar³

et al. 2009

Indian J Med Sci

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Section: Discussionsupporting

confidence: 59%

Comparison of efficacy of oral drotaverine plus mefenamic acid with paracervical block and with intravenous sedation for pain relief during hysteroscopy and endometrial biopsy

Sharma¹,

Aruna²,

Kumar³

et al. 2009

Indian J Med Sci

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“…Recent articles showed that the use of saline for distension instead of carbon dioxide gas reduces pain, and that vaginoscopy approach, developed by Bettocchi et al, with no need of speculum or tenaculum, seems to be well tolerated by patients (1,4,6,(17)(18)(19)(20)(21) . cOnclUSiOnS Outpatient diagnostic hysteroscopy with gas can be associated with moderate but tolerable discomfort (mean pain score of 6 in a 0 to 10 pain scale, with 91.4% acceptance to repeat the exam), with satisfying results.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of pain in outpatient diagnostic hysteroscopy with gas

Diniz

Depes

Santos

et al. 2010

Einstein (São Paulo)

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Objective: To evaluate the intensity of pain reported by patients undergoing outpatient diagnostic hysteroscopy. Methods: Exam performed with a 5-mm lens hysteroscope, vaginal speculum, tenaculum and uterine distention with carbon dioxide gas. Before and after the examination, patients were interviewed to define, in a verbal scale from 0 to 10, pain values that they expected to feel and that they experienced after the end, and also if they would repeat it if indicated. Data were analyzed using Statistical Package for the Social Sciences 15.0, statistic significance was defined as p < 0.05 with a study power of 95%. results: Fifty-eight patients were included with mean age of 50.9 years, with 32.8% at postmenopause and 6.9% nulliparous. Among those with previous deliveries, mean parity was 2.21 and at least one vaginal delivery had occurred in 63.8%. Only 24.1% of patients knew how the exam would be done, 62.1% needed an endometrial sample and the result was considered satisfactory in 89.7%. The means of expected and experienced pain were similar (6.0 versus 6.1), and 91.4% of women would repeat the hysteroscopy if necessary. The only factor associated with less pain after the exam was previous vaginal delivery, with a decrease of pain score from 7.1 to 5.5 (p = 0.03). Mean pain was significantly lower in those who agreed to repeat the exam (5.8 versus 9.4; p = 0.003). conclusions: Outpatient diagnostic hysteroscopy with gas can be associated with moderate but tolerable discomfort and satisfactory results.Keywords: Pain measurement; Pain measurement/diagnosis; Hysteroscopy/methods; Ambulatorial care; Outcome and process assessment (Health Care) reSUMO Objetivo: Avaliar a intensidade da dor referida pelas pacientes submetidas à histeroscopia diagnóstica ambulatorial. Métodos: Exame realizado com ótica de 5 mm, espéculo, pinçamento do colo com Pozzi e distensão da cavidade uterina com dióxido de carbono. Antes e depois do exame, as pacientes foram entrevistadas para definir, em uma escala verbal de 0 a 10, valores para espectativa de dor e dor experimentada após seu término, e também se elas o repetiriam se houvesse indicação. Os dados foram analisados no Statistical Package for the Social Sciences 15.0, com significância estatística definida como p < 0,05 e poder do teste de 95%. resultados: Foram incluídas 58 pacientes, com idade média de 50,9 anos, sendo 32,8% na pós-menopausa e 6,9% nulíparas. Dentre as pacientes com partos anteriores, a paridade média foi 2,21 e pelo menos um parto normal ocorreu em 63,8%. Apenas 24,1% das pacientes sabiam como o exame seria feito, 62,1% necessitaram de biópsia endometrial e o resultado foi considerado satisfatório em 89,7% dos casos. As médias de dor esperada e referida pelas pacientes foram semelhantes (6,0 versus 6,1), e 91,4% das mulheres repetiriam a histeroscopia quando necessário. O único fator associado à redução da dor após o exame foi o antecedente de parto normal, com queda de 7,1 para 5,5 (p = 0,03). A média de dor foi significativamente menor nas pacientes...

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“…Patients with conditions that could cause or contribute to pelvic pain were excluded. These factors were evaluated: dysmenorrhea, dyspareunia, a history of uterine surgery, chronic pelvic pain, previous caesarean section or cervical canal surgery [10,11]. In addition, pregnant and patients with gastro-oesophageal diseases, which could inhibit the use of rectal non-steroid and those using medication for allergies were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

The Effect of Intrauterine Lidocaine and Rectal Indomethacin on Pain during Office Vaginoscopic Hysteroscopy: Randomized Double-Blind Controlled Study

Şentürk¹,

Güraslan²,

Babaoğlu³

et al. 2015

Gynecol Obstet Invest

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Backgrounds/Aims: The aim of this study was to investigate the effect of rectal and intrauterine anesthesia during vaginoscopic hysteroscopy. Methods: This was a randomized, double-blind, placebo-controlled study. Patients were randomized to rectal indomethacin, intrauterine lidocaine and placebo groups. Patients with conditions that could cause or contribute to pelvic pain were excluded. Pain was evaluated with Visual Analog Scale, when the cervical canal was passed, while within the cavity and at 10 min after procedure. The Analog Pain Scale scores of the 3 groups were compared with the Kruskal-Wallis 1-way analysis of variance test. A value of p < 0.05 was accepted as statistically significant. Results: The study included a total of 206 patients. No difference was seen between the groups in respect of indication, age, gravid and duration of procedure. While the anesthesia was determined as superior to the placebo in reducing pain at all 3 stages (p < 0.05), intrauterine lidocaine was determined to be more effective than rectal indomethacin in reducing pain within the cavity and 10 min after the procedure (p < 0.05). Conclusion: Rectal or intrauterine anesthesia applied with the vaginoscopic technique is useful in hysteroscopy. However, intrauterine anesthesia is more effective in reducing pain.

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Predictive factors for pain experienced at office fluid minihysteroscopy

Cited by 44 publications

References 11 publications

Comparison of efficacy of oral drotaverine plus mefenamic acid with paracervical block and with intravenous sedation for pain relief during hysteroscopy and endometrial biopsy

Comparison of efficacy of oral drotaverine plus mefenamic acid with paracervical block and with intravenous sedation for pain relief during hysteroscopy and endometrial biopsy

Evaluation of pain in outpatient diagnostic hysteroscopy with gas

The Effect of Intrauterine Lidocaine and Rectal Indomethacin on Pain during Office Vaginoscopic Hysteroscopy: Randomized Double-Blind Controlled Study

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