Oral Tramadol Versus Diclofenac For Pain Relief Before Outpatient Hysteroscopy: A Randomized Controlled Trial

Abstract

Outpatient hysteroscopy is increasingly being used as a cost-effective alternative to in-patient hysteroscopy under general anaesthesia (De Iaco et al., 2000). The use of miniature hysteroscope and the vaginoscopic approach have made outpatient hysteroscopy more feasible, more convenient and less painful for many patients. However, some patients still experience pain during the procedure, which has been reported as a common cause of failure to complete the procedure (Critchley et al., 2004; Jivraj et al., 2004). 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 (Jivraj et al., 2004). Office hysteroscopy may be painful, even if it is performed by an experienced surgeon with a non-traumatic technique (De Iaco et al., 2000). This study aims to assess the efficacy, safety and women satisfaction of Tramadol and Diclofenac in relief of pain associated with diagnostic hysteroscopy.