Evaluation of different methods for pain management in office hysteroscopy

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Mansoura University Hospitals, Elgomhouria St., Mansoura City 35111, Dakahlia, Egypt

2 Department of Obstetrics and Gynecology, Mansoura University, Mansoura, Egypt

Abstract

Objective: : to detect the most effective pain control modality for the performance of office  Hysteroscopy.
Methods: This was a double-blind randomized comparative study. Both sample size and randomization were done by a computer program. Patients were classified into four groups: Group one received 50 mg diclofenac potassium orally 30 minutes before hysteroscopy, group two received lidocaine 2% gel applied to cervix 5 minutes before hysteroscopy, group three received 10 ml 2% lidocaine solution injection in the cervix, group four received placebo drugs before hysteroscopy. Adjustments were made so that the 4 groups receive the 3 forms of analgesic drugs either in active form or placebo to ensure the integrity of double-blind study. The woman was asked by an independent observer to evaluate the pain felt at different stages of the procedure using VAS.
Results: There was a statistically significant difference in two groups (oral NSAIDs and paracervical block) in the VAS.   
Conclusion: oral NSAIDs is an effective method in reducing pain during hysteroscopy. paracervical block reduce pain significantly only during introduction of hysteroscopy through the cervix, hindered by the time it takes, bleeding, lack of effectiveness through other stages of the procedure, while application of anesthetic gel though is proved to be an ineffective way to control pain during the procedures. 

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