Local anaesthesia for office hysteroscopy: A systematic review & meta-analysis.

De Silva, Prathiba M, Carnegy, Alasdair, Smith, Paul P and Clark, T Justin (2020) Local anaesthesia for office hysteroscopy: A systematic review & meta-analysis. European journal of obstetrics, gynecology, and reproductive biology, 252. pp. 70-81. ISSN 1872-7654.

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Official URL: https://www.ejog.org/article/S0301-2115(20)30346-8...

Abstract

OBJECTIVE

To compare the effects of different types and routes of administration of local anaesthetic for pain control during and after office hysteroscopy.

METHODS

Medline, Embase, CINAHL and the Cochrane library were searched from inception until October 2019, in order to perform a systematic review and meta-analysis of all randomised controlled trials investigating the use of a local anaesthetic compared to a control, for pain relief in women undergoing diagnostic or operative office hysteroscopy. Average pain scores and data regarding side-effects, feasibility, complications, acceptability and satisfaction were collected.

RESULTS

The literature search yielded 612 citations. A total of 37 studies were included for systematic review, of which data from 20 studies were used for meta-analysis. Local anaesthesia was associated with significantly reduced pain during (SMD -0.57, 95 % CI -0.79 to -0.34) and after (SMD -0.30, 95 % CI -0.54 to -0.06) office hysteroscopy but did not reduce vasovagal episodes (OR 0.73, 95 % CI 0.50-1.09). A reduction in intra-procedural pain was observed regardless of type or route of administration. Local anaesthesia did not significantly reduce the risk of procedural failure (OR 0.72, 95 % CI 0.47-1.11). Insufficient data regarding complications, acceptability and satisfaction were available for meta-analysis.

CONCLUSION

Local anaesthesia via any route of genital tract administration, should be considered when undertaking office diagnostic or operative hysteroscopy to reduce pain during and after the procedure. Further research is needed to understand whether the pain control benefits of local anaesthesia remain apparent with vaginoscopic approaches to office hysteroscopy that avoid genital tract instrumentation.

Item Type: Article
Subjects: WO Surgery > WO500 Anaesthesia
WP Gynaecology. Women’s health
Divisions: Planned IP Care > General Surgery
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Depositing User: Mrs Yolande Brookes
Date Deposited: 08 Jul 2020 15:28
Last Modified: 08 Jul 2020 15:28
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3244

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