Use of carbon dioxide versus normal saline for diagnostic hysteroscopy.
OBJECTIVE
To compare CO2 and normal saline as distention medium in diagnostic hysteroscopy.


METHODS
Prospective randomized study.


METHODS
University-based artificial insemination and sterility center in Italy.


METHODS
Seventy-four women who underwent hysteroscopy.


METHODS
Hysteroscopy was performed with CO2 or normal saline.


METHODS
Quality of intrauterine images, cervical dilatation, local anesthesia, and duration of the test. In addition, each patient evaluated pain during and after the examination, irritation of the phrenic plexus, analgesic use, and side effects.


RESULTS
The quality of the hysteroscopic image was statistically similar for both media. Dilatation of the cervical canal and use of local anesthesia was more often necessary in the CO2 group. The procedure time was 5.96 +/- 1.55 minutes in the CO2 group and 3.12 +/- 0.96 in the normal saline group. The CO2 group reported pain more frequently during and after the examination, shoulder pain, greater analgesic use, and more side effects.


CONCLUSIONS
For hysteroscopy, normal saline is technically equal to CO2 in terms of image quality and ease of use but offers more advantages. Hysteroscopy with normal saline is more acceptable to patients, quicker to perform, and entails fewer additional procedures.
Centro Sterilità e Fecondazione Assistita, Dipartimento Materno-Infantile, Università degli Studi di Perugia-Azienda Ospedaliera di Perugia, Perugia, Italy. brusco@centrosterilita.com
Gian Francesco
GF
Brusco
Saverio
S
Arena
Antonio
A
Angelini
D000328:Adult; D002245:Carbon Dioxide; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D012965:Sodium Chloride; D014591:Uterine Diseases / Q000175:diagnosis*
D002245:Carbon Dioxide; D012965:Sodium Chloride