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Identifying predictors of unacceptable pain at office hysteroscopy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	de Freitas Fonseca, Márlon Sessa, Felipe V. Resende, José Anacleto D. Guerra, Camilla Gabriely S. Andrade, Claudio M. Crispi, Claudio P.
Spatial Coverage	Canada
Description	Author Affiliation: de Freitas Fonseca M ( Departments of Anesthesiology and Gynecology, Instituto Fernandes Figueira, Rio de Janeiro, Brazil. Electronic address: marlon@iff.fiocruz.br.); Sessa FV ( Departments of Anesthesiology and Gynecology, Instituto Fernandes Figueira, Rio de Janeiro, Brazil.); Resende JA ( Departments of Anesthesiology and Gynecology, Instituto Fernandes Figueira, Rio de Janeiro, Brazil); Guerra CG ( Departments of Anesthesiology and Gynecology, Instituto Fernandes Figueira, Rio de Janeiro, Brazil.); Andrade CM ( Department of Gynecology, Centro de Video-Endoscopia, Rio de Janeiro, Brazil.); Crispi CP ( Department of Gynecology, Centro de Video-Endoscopia, Rio de Janeiro, Brazil.)
Abstract	STUDY OBJECTIVE: To identify predictors of unacceptable pain during office hysteroscopy without anesthesia. DESIGN: Prospective observational study (Canadian Task Force classification II-2). SETTING: Teaching hospital. PATIENTS: Five hundred fifty-eight women aged 17 to 73 years. INTERVENTION: Elective office hysteroscopy without anesthesia. MEASUREMENTS AND MAIN RESULTS: Pain intensity was assessed via a verbal rating scale (VRS, 0-10). Pain was considered unacceptable when severe during the procedure (VRS ≥7) or moderate to severe at discharge (VRS ≥4). After preliminary statistical analysis, factors including diabetes, age ≤50 years, previous curettage, dyspareunia, severe dysmenorrhea, and hysteroscopist experience were selected to compose 2 binary multivariate models to predict unacceptable pain. As expected, hysteroscopist experience was protective against unacceptable pain during office hysteroscopy (p = .03; adjusted odds ratio [OR], 0.63; 95% confidence interval [CI], 41-96) and also at discharge (p = .002; adjusted OR, 0.48; 95% CI, 30-77). Severe dysmenorrhea was a significant risk factor for pain (cramps) at discharge (p < .001; adjusted OR, 3.07; 95% CI, 1.97-4.78). CONCLUSION: Women with severe dysmenorrhea will benefit from preemptive analgesia regardless of hysteroscopist level of experience because this condition significantly increased the occurrence of unacceptable cramps at discharge.
File Format	HTM / HTML
ISSN	15534650
Issue Number	4
Volume Number	21
e-ISSN	15534669
Journal	Journal of Minimally Invasive Gynecology
Language	English
Publisher	Elsevier
Publisher Date	2014-07-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Hysteroscopy Research Support, Non-u.s. Gov't Prospective Studies Age Factors Humans Middle Aged Journal Article Patient Satisfaction Young Adult Pain Etiology Adult Female Odds Ratio Adverse Effects Risk Factors Pain, Postoperative Logistic Models Canada Dyspareunia Ambulatory Surgical Procedures Adolescent Aged Discipline Gynecology Pain Measurement Dysmenorrhea Observational Study
Content Type	Text
Resource Type	Article
Subject	Obstetrics and Gynecology

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