Diclofenac versus a combination of hyoscine and diclofenac for outpatient hysteroscopy: a placebo controlled randomized clinical trial

to compare the effect of administering diclofenac sodium and/or oral hyoscine in pain perception during and after outpatient diagnostic hysteroscopy without anesthesia.
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - Category: OBGYN Authors: Tags: Full length article Source Type: research

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Authors: Ajmi A, Das S Abstract Endometrial ablation in outpatient setting is associated with shorter hospital stay and quicker recovery. The primary outcome of this observational study was initiation and completion of procedure and secondary outcome measures were pain during the procedure and complications. The study was conducted in outpatient women's health clinic of Bolton Foundation NHS Trust UK, between March 2015 and July 2017. Out of 151 patients, all had oral analgesia at home. The procedure was initiated and completed in 83% cases. The median time for procedure was 78.5 s with range (34-120 ...
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research
Conclusion(s)Office hysteroscopy is a well tolerated procedure and prior use of analgesic medication was not effective in decreasing pain. In selected patients with chronic pelvic pain the use prior analgesic medication may be beneficial.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
Authors: Jakopič Maček K, Blaganje M, Kenda Šuster N, Drusany Starič K, Kobal B Abstract Data of 101 patients with retained products of conception (RPOC), treated with office hysteroscopy (OH) from 2012 to 2015 at the University Medical Centre Ljubljana were analysed. Patients with>30 mm RPOC thickness or strong vascularisation on ultrasound (US) were excluded. Procedures were successfully completed in 94/101 (93%). Mean duration was 18 min (4-60), patient pain estimation with VAS was 2.3 (0-8). No intraoperative complications > Grade II according to Clavien-Dindo classif...
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research
Discussion and conclusionThe Authors, as a result of the present study, suggest that office hysteroscopy should be sussessful at the first attempt, because the majority of patients (58%), in case of a failed procedure, do not undergo a repeat hysteroscopy in a reasonable time and important diagnosis, such as that of endometrial cancer, may be missed or delayed. In order to increase the procedure success rate, prior to the scheduled hysteroscopy they recommend to counsel all patients, identifying those who may benefit from pharmacological cervical softening, local anesthetic injection or the use of small caliber hysteroscopes.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
ConclusionHysteroscopy as a safe and relatively low pain procedure. Local anesthetic in the form of a paracervical block has been used historically to decrease pain during the procedure. Paracervical block does not significantly decrease pain during procedure, even in menopausal women who were found to have higher pain scales on average. Therefore, future studies should further investigate strategies to decrease pain during office hysteroscopy especially for postmenopausal women.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
ConclusionsHysteroscopic anesthesia allows for a well tolerated procedure, regardless of lesion location during office hysteroscopy. Lesion location should not be regarded as a technical limitation.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Authors: Bennett A, Lepage C, Thavorn K, Fergusson D, Murnaghan O, Coyle D, Singh SS Abstract Traditionally, hysteroscopy has been performed in the main operating room with the patient under general anaesthesia. Hysteroscopy performed in an office setting avoids the risks of general anaesthesia. The aim of this review was to evaluate the effectiveness of outpatient hysteroscopy compared with hysteroscopy performed in the operating room to diagnose and/or treat intrauterine pathology. Relevant electronic databases were searched, including Medline, EMBASE, and the Cochrane Library. RCTs and nonrandomized studies that...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
This study evaluates the effect of intrauterine lidocaine on the patient's pain score during endometrial biopsy by the Novak curette. We included patients aged 35 years or more who had abnormal uterine bleeding between December 2016 and March 2018. The study was conducted at Thammasat University Hospital, Pathum Thani, Thailand. 250 patients were randomly allocated to either receive intrauterine lidocaine (study group) or normal saline (control group). Assessment of pain severity was evaluated using a visual analogue scale (VAS) score at 6 time-points, namely, before performing the procedure, when grasping the cervix by th...
Source: Pain Physician - Category: Anesthesiology Authors: Tags: Pain Res Treat Source Type: research
Abstract Background: The clinical efficacy of fentanyl for pain control differs greatly across individuals. The purpose of this study was to investigate the impact of CYP3A4*1G polymorphism including wild-type homozygote (CYP3A4*1/*1, GG), mutant heterozygote (CYP3A4*1/*1G, GA), and mutant homozygote (CYP3A4*1G/*1G, AA) on fentanyl analgesia in Chinese patients undergoing hysteroscopy by the assessment of analgesia nociception index (ANI). Methods: A total of 200 gynecologic patients scheduled for elective hysteroscopy under general anesthesia at Peking University People's Hospital from May to December in 201...
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
Conclusion: Dexmedetomidine and remifentanil are both efficacious agents for perioperative analgesia in hysteroscopy cases. PMID: 30284585 [PubMed - in process]
Source: Saudi Medical Journal - Category: Middle East Health Tags: Saudi Med J Source Type: research
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