1. Nitrous oxide versus lidocaine versus no analgesic for in‐office hysteroscopy: a randomised clinical trial.
- Author
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Solano Calvo, JA, Valle Rubido, C, Rodríguez‐Miguel, A, Abajo, FJ, Delgado Espeja, JJ, González Hinojosa, J, Fernández Muñoz, L, and Zapico Goñi, Á
- Subjects
HYSTEROSCOPY ,NITROUS oxide ,LIDOCAINE ,VISUAL analog scale ,PAIN management ,NECK pain ,CLINICAL trials - Abstract
Objective: To compare the effect of inhaled nitrous oxide (INO) on pain control during in‐office hysteroscopy with 1% lidocaine paracervical infiltration and no analgesic. Design: Single‐blind stratified randomised clinical trial with masked assessment by a third party. Setting: Department of Obstetrics and Gynaecology in a Spanish hospital. Population: Women who underwent hysteroscopy. Methods: Patients were stratified into three groups according to the purpose of the hysteroscopy (biopsy, polypectomy or tubal sterilisation) and then assigned to different treatment groups through a permuted‐blocks randomisation within strata. Pain scale was provided by a gynaecologist totally blinded to procedures and treatments. Effects were assessed using a one‐way analysis of variance following an intention‐to‐treat approach. Main outcome measures: Visual analogue scale (VAS) from 0 to 100 mm. Results: A total of 314 women were included: 105 to INO, 104 to 1% lidocaine and 105 to no analgesic. Baseline characteristics were comparable. Mean VAS score after the procedure was 34.7 ± 25.8 mm, 36.1 ± 22.9 mm (P = 1.0) and 47.3 ± 28.2 mm (P = 0.001) for INO, 1% lidocaine and no analgesic, respectively. No adverse events were reported in 91 (86.7%) patients in the INO group compared with 79 (76%) in the 1%‐lidocaine group (P = 0.04) and 85 (81%) in the no‐analgesic group (P = 0.26). Conclusion: INO was as effective as 1% lidocaine in pain control for in‐office hysteroscopy and was better tolerated. The no‐analgesic group presented the poorer results, so was the least recommended clinical option. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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