Pain management in outpatient hysteroscopy

Publication date: Available online 13 September 2016 Source:Gynecology and Minimally Invasive Therapy Author(s): Cristina del Valle, Juan Antonio Solano, Antonio Rodríguez, Mónica Alonso We have performed a review of literature to find evidence on the effectiveness of the different methods used to decrease pain perception during office hysteroscopy and identify risk factors of a painful hysteroscopy. Our methods include a review of literature following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) Guidelines for Systematic Reviews of Observational Studies; a literature search of MEDLINE, Embase, PubMed, and the Cochrane Library of Systematic Reviews; and reference search in selected papers, looking for meta-analysis and randomized controlled trials that assess pain management in office hysteroscopy and studies that identify risk factors for painful hysteroscopy. Review for appropriateness and allocation according to type of analgesic method was performed, together with evaluation for risk factors and evidence of pain reduction effects of pharmacological and nonpharmacological analgesic methods. Nonpharmacological methods, such as vaginoscopy or minihysteroscopes, are advisable to avoid producing pain. The only pharmacological method that has demonstrated its effectiveness in several meta-analysis and reviews is paracervical block, reducing pain during and 30 minutes after hysteroscopy. Nonsteroidal anti-inflammatory drugs (NSAIDs) seem to be usef...
Source: Gynecology and Minimally Invasive Therapy - Category: OBGYN Source Type: research