Outpatient hysteroscopy: an observational study of patient acceptability.
OBJECTIVE
To assess the patient acceptability of outpatient hysteroscopy when Prilocaine is used as analgesia and to determine if our practice of using Prilocaine only if indicated by pain is appropriate.


METHODS
Prospective observational study of 100 consecutive patients undergoing outpatient hysteroscopy.


RESULTS
One hundred consecutive women attending for outpatient hysteroscopy, completed questionnaires after the procedure, indicating the level of pain experienced on an analogue scale. Prilocaine hydrochloride (40 mg/ml) had been administered as an intracervical block only if a patient experienced pain or if cervical dilatation was required. Patients expressed significantly more pain during hysteroscopy than after hysteroscopy whether Prilocaine was used or not. The median pain score was significantly higher in the group that required local anesthetic. There was a greater desire to have the procedure done under general anesthesia when Prilocaine was used than when it was not used.


CONCLUSIONS
Pain is a determining factor in patient acceptability of outpatient hysteroscopy and is a likely reason for some women to opt to have a hysteroscopy under general anesthesia. The practice of administering Prilocaine only if needed is inappropriate. Future studies should now aim to determine the optimal drug, dose, and timing of administration of analgesia in pre-selected women who are likely to experience pain and hence benefit from analgesia.
Jivraj
Shehnaaz
S
Royal Hallamshire Hospital, United Kingdom. sjivraj007@aol.com
Dass
Meena
M
Panikkar
Jane
J
Brown
Valerie
V
D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects; D010045:Outpatients; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011318:Prilocaine / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D011795:Surveys and Questionnaires
D000779:Anesthetics, Local; D011318:Prilocaine