Efficacy of intravenous tramadol treatment for reducing pain during office diagnostic hysteroscopy

Floris, Stefano; Piras, Bruno; Orrù, Marisa; Silvetti, Enrico; Tusconi, Anna; Melis, Francesca; Tuveri, Milena; Piga, Marco; Paoletti, Anna Maria; Melis, Gian Benedetto

doi:10.1016/j.fertnstert.2006.05.072

Cited by 66 publications

(25 citation statements)

References 22 publications

(32 reference statements)

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“…A great part of the discomfort attributed to the exam is caused by uterine contraction, so it was supposed that prostaglandin synthesis inhibitors could decrease pain, but when the mephenamic acid was used one hour before the exam, the discomfort was similar to the placebo group during the procedure, only being significant after the said procedure (12) . Similar results were found when intravenous tramadol and sublingual buprenorphine were used (13)(14) . Some authors, studying local intrauterine anesthesia with lidocaine diluted in saline alone or combined with cervical anesthesia affirmed that this procedure may be even more painful that the exam itself (4,15) .…”

Section: Discussionsupporting

confidence: 80%

Evaluation of pain in outpatient diagnostic hysteroscopy with gas

Diniz

Depes

Santos

et al. 2010

Einstein (São Paulo)

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Objective: To evaluate the intensity of pain reported by patients undergoing outpatient diagnostic hysteroscopy. Methods: Exam performed with a 5-mm lens hysteroscope, vaginal speculum, tenaculum and uterine distention with carbon dioxide gas. Before and after the examination, patients were interviewed to define, in a verbal scale from 0 to 10, pain values that they expected to feel and that they experienced after the end, and also if they would repeat it if indicated. Data were analyzed using Statistical Package for the Social Sciences 15.0, statistic significance was defined as p < 0.05 with a study power of 95%. results: Fifty-eight patients were included with mean age of 50.9 years, with 32.8% at postmenopause and 6.9% nulliparous. Among those with previous deliveries, mean parity was 2.21 and at least one vaginal delivery had occurred in 63.8%. Only 24.1% of patients knew how the exam would be done, 62.1% needed an endometrial sample and the result was considered satisfactory in 89.7%. The means of expected and experienced pain were similar (6.0 versus 6.1), and 91.4% of women would repeat the hysteroscopy if necessary. The only factor associated with less pain after the exam was previous vaginal delivery, with a decrease of pain score from 7.1 to 5.5 (p = 0.03). Mean pain was significantly lower in those who agreed to repeat the exam (5.8 versus 9.4; p = 0.003). conclusions: Outpatient diagnostic hysteroscopy with gas can be associated with moderate but tolerable discomfort and satisfactory results.Keywords: Pain measurement; Pain measurement/diagnosis; Hysteroscopy/methods; Ambulatorial care; Outcome and process assessment (Health Care) reSUMO Objetivo: Avaliar a intensidade da dor referida pelas pacientes submetidas à histeroscopia diagnóstica ambulatorial. Métodos: Exame realizado com ótica de 5 mm, espéculo, pinçamento do colo com Pozzi e distensão da cavidade uterina com dióxido de carbono. Antes e depois do exame, as pacientes foram entrevistadas para definir, em uma escala verbal de 0 a 10, valores para espectativa de dor e dor experimentada após seu término, e também se elas o repetiriam se houvesse indicação. Os dados foram analisados no Statistical Package for the Social Sciences 15.0, com significância estatística definida como p < 0,05 e poder do teste de 95%. resultados: Foram incluídas 58 pacientes, com idade média de 50,9 anos, sendo 32,8% na pós-menopausa e 6,9% nulíparas. Dentre as pacientes com partos anteriores, a paridade média foi 2,21 e pelo menos um parto normal ocorreu em 63,8%. Apenas 24,1% das pacientes sabiam como o exame seria feito, 62,1% necessitaram de biópsia endometrial e o resultado foi considerado satisfatório em 89,7% dos casos. As médias de dor esperada e referida pelas pacientes foram semelhantes (6,0 versus 6,1), e 91,4% das mulheres repetiriam a histeroscopia quando necessário. O único fator associado à redução da dor após o exame foi o antecedente de parto normal, com queda de 7,1 para 5,5 (p = 0,03). A média de dor foi significativamente menor nas pacientes...

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Section: Discussionsupporting

confidence: 80%

Evaluation of pain in outpatient diagnostic hysteroscopy with gas

Diniz

Depes

Santos

et al. 2010

Einstein (São Paulo)

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“…Other studies have resorted to pharmacologic approaches (9)(10)(11), which at times can be relatively invasive (10,12), to find a solution for pain during hysteroscopy; but besides not reaching consensus on their actual effectiveness (13), those studies also altered the outpatient nature of the procedure (14).…”

mentioning

confidence: 99%

Pain in diagnostic hysteroscopy: a multivariate analysis after a randomized, controlled trial

Mazzon

Favilli

Grasso

et al. 2014

Fertility and Sterility

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“…In the randomized, controlled, double blind study by Floris et al intravenous (iv) tramadol given 30 minutes prior to hysteroscopy was effective in reducing the discomfort during and pain after the procedure (13). Several previous case reports suggested that tramadol, an opioid analgesic, could be associated with abuse potential (20,21,22).…”

Section: Discussionmentioning

confidence: 99%

“…Tramadol is commonly utilized for the treatment of postoperative pain in gynaecology and obstetrics (12). Intravenous tramadol has been reported to be effective in reducing pain occurring during and after office hysteroscopy (13). However, the role of oral tramadol in reducing pain during office hysteroscopy has not been tested previously.…”

Section: Introductionmentioning

confidence: 99%

Analgesic Efficiency of Tramadol Administered Prior to Hysteroscopy Procedure

Kadiroğullari

Seçkin

Yücel

et al. 2016

Gynecol Obstet Reprod Med

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OBJECTIVE:In this study, our objective was to assess the pain scores using the Visual Analogue Scale (VAS) in patients who were given tramadol prior to office hysteroscopy in order to demonstrate its analgesic activity when given before this procedure. STUDY DESIGN:This prospective study conducted in year 2015 included two group of patients undergoing office hysteroscopy that were defined on the basis of the type of analgesia. Patients in the first group (Group 1, n=44) received oral tramadol prior to the procedure, while patients in the other group (Group 2, n=44) received placebo. VAS scores were determined during (0 minutes) and after (15 minutes) the procedure. RESULTS:There were no significant differences between groups in terms of age, parity and body mass index (p>0.05). Comparison of VAS scores at 0 and 15 minutes, lower values were observed in tramadol patients at 0 minutes (p<0.05), while scores at 15 minutes were not significantly different between the groups (p>0.05). CONCLUSIONS:Although oral tramadol given prior to office hysteroscopy was effective and safe in reducing pain during the procedure, it is not useful for the pain that occurs after processing.

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Efficacy of intravenous tramadol treatment for reducing pain during office diagnostic hysteroscopy

Cited by 66 publications

References 22 publications

Evaluation of pain in outpatient diagnostic hysteroscopy with gas

Evaluation of pain in outpatient diagnostic hysteroscopy with gas

Pain in diagnostic hysteroscopy: a multivariate analysis after a randomized, controlled trial

Analgesic Efficiency of Tramadol Administered Prior to Hysteroscopy Procedure

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