Lidocaine Infusion on Hysteroscopic Media versus Oral Diclofenac for Pain Relief during Outpatient Hysteroscopy A Randomized Controlled Trial

Abstract

utpatient hysteroscopy, also known as office hysteroscopy, is an established diagnostic tool (Pinto, 2011). The procedure involves mini autorised endoscopic device to visualise and examine the uterine cavity, without the need for operating room facilities or anaesthesia (Clark and Gupta, 2002). One of the main causes of procedure failure is patient discomfort and pain. Pain associated with hysteroscopy occurs during insertion of the speculum, dilatation of the cervix for insertion of hysteroscope (non vaginoscopic approach), distention of the uterine cavity with distention medium, and direct stimulation of the uterine wall by the hysteroscope. Office hysteroscopy may be painful, even if it is performed by an experienced surgeon with a non-traumatic technique (De Iaco et al., 2000). Known risk factors include nullparity, cervical stenosis, chronic pelvic pain, anxiety and menopause, as well as hysteroscope diameter, operative time and characteristics of the intrauterine lesion (location, shape and size) (Agdi et al., 2010). This study aims to assess the efficacy, safety, and women satisfaction of Diclofenac and Lidocaine in relief of pain associated with diagnostic hysteroscopy.