Comparative study of pain perception in outpatient hysteroscopy analyzing previous orientation by multimedia
Walter Antônio Prata Pace, Ana Luiza Loiola Pace, Andréa Alves Morato, Francisco de Assis Nunes Pereira, Gabriela Loiola Pace, João Oscar de Almeida Falcão Junior
Abstract
Objectives: To evaluate the impact of previous guidance on the hysteroscopy exam using multimedia resources (film) compared to verbal orientations only, on the pain intensity perceived by the patient during hysteroscopy without anesthesia. Methods: Randomized clinical trial, which included 187 women, who were referred for hysteroscopy. The patients in the experimental group (89) watched an explanatory video just before the exam. The control group (98), however, received only routine verbal guidance about the exam. The degree of pain perceived by all patients was measured 1 and 5 minutes after the procedure using Visual Analog Scale. Results: In the experimental group, 1 minute after the examination, 29.2% of the patients reported mild pain, 24.7% moderate pain and 46.1% severe pain. In the control group, 28.6% of the patients reported mild pain, 29.6% moderate pain and 41.8% severe pain. In the analysis 5 minutes after the examination of the experimental group 60.7% of the patients reported mild pain, 28.1% moderate pain and 11.2% severe pain and the control group 62.3% of the patients reported mild pain, 26.5% moderate pain and 11.2% severe pain. Conclusions: The study was not able to demonstrate the relationship of pain perceived by patients with prior multimedia orientation, thus that, more studies are needed.
Keywords
References
1. Teran-Alonso MJ, De Santiago J, Usandizaga R, Zapardiel I. Evaluation of pain in office hysteroscopy with prior analgesic medication: a prospective randomized study. Eur J Obstet Gynecol Reprod Biol. 2014;178:123-7. http://dx.doi.org/10.1016/j.ejogrb.2014.04.030. PMid:24835860.
2. Munro MG, Storz K, Abbott JA, Falcone T, Jacobs VR, Muzii L, et al. AAGL practice report: practice guidelines for the management of hysteroscopic distending media. J Minim Invasive Gynecol. 2013;20(2):137-48. http://dx.doi.org/10.1016/j.jmig.2012.12.002. PMid:23465255.
3. De Angelis C, Santoro G, Re ME, Nofroni I. Office hysteroscopy and compliance: mini-hysteroscopy versus traditional hysteroscopy in a randomized trial. Hum Reprod. 2003;18(11):2441-5. http://dx.doi.org/10.1093/humrep/deg463. PMid:14585898.
4. Yen CF, Chou HH, Wu HM, Lee C-L, Chang T-C. Effectiveness and appropriateness in the application of office hysteroscopy. J Formos Med Assoc. 2019;118(11):1480-7. http://dx.doi.org/10.1016/j.jfma.2018.12.012. PMid:30611636.
5. Almeida ZMMC, Pontes R, Costa HLFF. Avaliação da dor na histeroscopia diagnóstica por vaginoscopia utilizando-se, como meio de distensão, solução salina à temperatura corporal: Ensaio clínico randomizado. Rev Bras Ginecol Obstet. 2008;30(1):25-30.
6. Hassan A, Wahba A, Haggag H. Tramadol versus Celecoxib for reducing pain associated with outpatient hysteroscopy: a randomized double-blind placebo-controlled trial. Hum Reprod. 2016;31(1):60-6. http://dx.doi.org/10.1093/humrep/dev291. PMid:26621854.
7. Salazar CA, Isaacson KB. Office operative hysteroscopy: an update. J Minim Invasive Gynecol. 2018;25(2):199-208. http://dx.doi.org/10.1016/j.jmig.2017.08.009. PMid:28803811.
8. Issat T, Beta J, Nowicka MA, Maciejewski T, Jakimiuk AJ. A randomized, single blind, placebo-controlled trial for the pain reduction during the outpatient hysteroscopy after ketoprofen or intravaginal misoprostol. J Minim Invasive Gynecol. 2014;21(5):921-7. http://dx.doi.org/10.1016/j.jmig.2014.04.006. PMid:24768981.
9. Cooper NA, Smith P, Khan KS, Clark TJ. Vaginoscopic approach to outpatient hysteroscopy: a systematic review of the effect on pain. BJOG. 2010;117(5):532-9. http://dx.doi.org/10.1111/j.1471-0528.2010.02503.x. PMid:20374594.
10. Bakour SH, Jones SE, O’Donovan P. Ambulatory hysteroscopy: evidence-based guide to diagnosis and therapy. Best Pract Res Clin Obstet Gynaecol. 2006;20(6):953-75. http://dx.doi.org/10.1016/j.bpobgyn.2006.06.004. PMid:17116420.
11. Cooper NA, Smith P, Khan KS, Clark TJ. A systematic review of the effect of the distension medium on pain during outpatient hysteroscopy. Fertil Steril. 2011;95(1):264-71. http://dx.doi.org/10.1016/j.fertnstert.2010.04.080. PMid:20576262.
12. Bradley LD. Overview of hysteroscopy. Massachusetts: UpToDate; 2010.
13. Diniz DBFQ, Depes DB, Santos AMG, David SD, Yatabe S, Lopes RGC. Avaliação da dor na histeroscopia diagnóstica ambulatorial com gás. Einstein. 2010;8(1):24-8. http://dx.doi.org/10.1590/s1679-45082010ao1342. PMid:26761748.
14. Rosa e Silva JC, Nascimento AD, Silva ACJSR, Poli Neto OB, Barbosa HF, Reis FJC, et al. Uso do spray de lidocaína em histeroscopia diagnóstica. Rev Bras Ginecol Obstet. 2007;29(4):181-5. http://dx.doi.org/10.1590/S0100-72032007000400003.
15. Cicinelli E. Histeroscpy without anestesia: review of recente literature. J Minim Invasive Gynecol. 2010;17(6):703-8. http://dx.doi.org/10.1016/j.jmig.2010.07.003. PMid:20955981.
16. Diniz DBFQ, Depes DDB, Pereira AMG, David SD, Lippi UG, Baracat FF, et al. Avaliação da dor em histeroscopia ambulatorial: comparação entre duas técnicas. Rev Bras Ginecol Obstet. 2010;32(1):26-32. http://dx.doi.org/10.1590/S0100-72032010000100005. PMid:20209259.
17. Luscombe KS, McDonnell NJ, Muchatuta NA, Paech MJ, Nathan EA. A randomised comparison of parecoxib versus placebo for pain management following minor day stay gynaecological surgery. Anaesth Intensive Care. 2010;38(1):141-8. http://dx.doi.org/10.1177/0310057X1003800123. PMid:20191790.
18. Hassan A, Haggag H. Role of oral tramadol 50 mg in reducing pain associated with outpatient hysteroscopy: a randomised doubleblind placebo-controlled trial. Aust N Z J Obstet Gynaecol. 2016;56(1):102-6. http://dx.doi.org/10.1111/ajo.12431. PMid:26817525.
19. Fouda UM, Gad Allah SH, Elshaer HS. Optimal timing of misoprostol administration in nulliparous women undergoing office hysteroscopy: a randomized double-blind placebo-controlled study. Fertil Steril. 2016;106(1):196-201. http://dx.doi.org/10.1016/j.fertnstert.2016.03.022. PMid:27037462.
20. Floris S, Piras B, Orrù M, Silvetti E, Tusconi A, Melis F, et al. Efficacy of intravenous tramadol treatment for reducing pain during office diagnostic hysteroscopy. Fertil Steril. 2007;87(1):147-51. http://dx.doi.org/10.1016/j.fertnstert.2006.05.072. PMid:17081540.
21. Ahmad G, O’Flynn H, Attarbashi S, Duffy JM, Watson A. Pain relief for outpatient hysteroscopy. Cochrane Database Syst Rev. 2009;(11):CD007710. http://dx.doi.org/10.1002/14651858.CD007710.pub3. PMid:21069695.
22. Angioli R, De Cicco Nardone C, Plotti F, Cafà EV, Dugo N, Damiani P, et al. Use of music to reduce anxiety during office hysteroscopy: prospective randomized trial. J Minim Invasive Gynecol. 2014;21(3):454-9. http://dx.doi.org/10.1016/j.jmig.2013.07.020. PMid:23962572.
23. White JM. Music as intervention: a notable endeavor to improve patient outcomes. Nurs Clin North Am. 2001;36(1):83-92. PMid:11342404.
24. Lau WC, Ho RY, Tsang MK, Yuen PM. Patients acceptance of outpatient hysteroscopy. Gynecol Obstet Invest. 1999;47(3):191-3. http://dx.doi.org/10.1159/000010092. PMid:10087415.
25. YouTube. Informativo sobre videohisteroscopia ambulatorial [Internet]. 2017 [cited 2019 Nov 26]. Available from: https://youtu.be/TfRhbaXtz0I
26. Vilos GA, Abu-Rafea B. New developments in ambulatory hysteroscopic surgery. Best Pract Res Clin Obstet Gynaecol. 2005;19(5):727-42. http://dx.doi.org/10.1016/j.bpobgyn.2005.06.012. PMid:16126460.
27. Allen RH, Micks E, Edelman A. Pain relief for obstetric and gynecologic ambulatory procedures. Obstet Gynecol Clin North Am. 2013;40(4):625-45. http://dx.doi.org/10.1016/j.ogc.2013.08.005. PMid:24286993.
Submitted date:
09/04/2019
Accepted date:
11/21/2019
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email