Patient-controlled sedation for outpatient thermal balloon endometrial ablation.
OBJECTIVE
To evaluate the effectiveness, safety, and patient satisfaction with patient-controlled sedation during thermal balloon endometrial ablation.


METHODS
Prospective observational study (Canadian Task Force classification II-2).


METHODS
University-affiliated teaching hospital.


METHODS
Thirty consecutive women with idiopathic menorrhagia refractory to medical treatment.


METHODS
Thermal balloon endometrial ablation under patient-controlled sedation with a mixture of propofol and alfentanil through an analgesia pump.


RESULTS
Pain was assessed using a descriptive pain score and the procedure was divided into four stages for assessment: catheter insertion, preheating phase, treatment cycle, and end of treatment. Patient satisfaction was assessed using the 8-item client satisfaction questionnaire. The procedure was well tolerated with good cooperation and no oversedation. Preheating was the most painful, and pain could be alleviated by asking the patient to self-administer a bolus of anesthesia before that phase. The median consumption of propofol was 35 mg (range 0-70 mg) and of alfentanil was 175 microg (range 50-200 microg). There were no intraoperative complications and the overall success rate in treating menorrhagia was 87%. Over 85% of the women did not think that general anesthesia was necessary. They all were highly satisfied and would recommend the procedure to others.


CONCLUSIONS
Patient-controlled sedation is a safe and effective method of alleviating pain and discomfort during thermal balloon ablation and is well accepted by patients.
Lok
Ingrid Hung
IH
Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
Chan
Matthew
M
Tam
Wing Hung
WH
Leung
Pui Ling
PL
Yuen
Pong Mo
PM
D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D016292:Procedural Sedation / Q000379:methods; D003613:Danazol / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D008595:Menorrhagia / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D010147:Pain Measurement; D010349:Patient Compliance; D011336:Probability; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D003613:Danazol; D015742:Propofol