The effect of diluted ropivacaine in distending fluid on cramping pain after hysteroscopic surgeries: a randomized clinical trial study

Abstract

ObjectiveHysteroscopy helps gynecologists diagnose and manage intrauterine abnormalities and pathology. Some patients experience suprapubic cramping pain for a few days after surgery. Ropivacaine, a local anesthetic, has a faster effect with longer duration than some other drugs in its category, and is less toxic to the central nervous system. The effect of ropivacaine on postoperative hysteroscopy has not yet been evaluated; this study investigated the effect of diluted ropivacaine in distending media during hysteroscopy on postoperative cramping pain. MethodsThis double-blind randomized clinical trial was conducted on 60 women who underwent hysteroscopy at a tertiary hospital. Normal saline was used as the distending fluid in both groups. The intervention group received 10 mL of 2% ropivacaine in only one bottle of 1,000 mL normal saline as a distending fluid, while the control group received 10 cc of normal saline in 1,000 mL normal saline during hysteroscopy. Patients' pain scores were evaluated before hysteroscopy and at 2, 6, 12, 24, and 48 hours after hysteroscopy. ResultsBased on the results, the pain measured by visual analog scale (VAS) score was significant at 6 and 12 hours after the intervention was significantly lower than that in the ropivacaine group ([3.03±1.57 vs. 4±1.49, P=0.02 at 6 hours) and (1.28±1.36 vs. 2.4±1.43, P=0.003 at 12 hours]). There were no significant differences in the VAS scores at 2, 24, and 48 hours after the intervention between the two groups. ConclusionRopivacaine in the distending fluid during hysteroscopy is associated with a significant reduction in pain within a few hours after hysteroscopy with no remarkable adverse effects.

Inhalation anesthesia with methoxyflurane for office hysteroscopy

“…Знеболювання з протитривожним ефектом є хорошою альтернативою для пацієнток із тривожністю та очікуванням болючих процедур [13]. LGH Cornelissen та співавтори (2021) продемонстрували доцільність виконання терапевтичних гістероскопій зі зниженням тривожності пацієнток в амбулаторних умовах, з низькими показниками болю та високим рівнем їхньої задоволеності [14][15][16].…”