title: Efficacy of intravenous tramadol treatment for reducing pain during office diagnostic hysteroscopy.
abstract: OBJECTIVE
  To assess whether IV tramadol before outpatient hysteroscopy could reduce procedure-related pain.
  
  
  METHODS
  A randomized double-blind placebo controlled trial.
  
  
  METHODS
  Outpatient Hysteroscopy Centre in the Department of Obstetrics and Gynaecology of Cagliari University.
  
  
  METHODS
  Fifty healthy, parous, women who underwent outpatient diagnostic hysteroscopy and endometrial biopsy.
  
  
  METHODS
  Random IV infusion of tramadol or placebo before hysteroscopy and endometrial biopsy were performed.
  
  
  METHODS
  Visual analogue scale of pain was measured both immediately after and 15 minutes after the procedure. Stress hormones (ACTH, cortisol), blood pressure, and heart frequency were evaluated before, during, and 15 minutes after the procedure.
  
  
  RESULTS
  In the tramadol group, the visual analogue scale of pain was significantly lower than in the placebo group both immediately after the procedure and 15 minutes later. Basal levels of ACTH and cortisol did not differ between the groups. In both groups, the ACTH levels remained unchanged during the study, and the cortisol levels were higher 15 minutes after the procedure than before the procedure. Procedure time, heart frequency, blood pressure, and adverse effects did not differ between the groups.
  
  
  CONCLUSIONS
  In parous women without uterine malformations, a treatment with tramadol before hysteroscopy and endometrial biopsy appears to be capable of reducing the pain and discomfort that are associated with this procedure.
authors.affiliation: Dipartimento Chirurgico Materno Infantile e di Scienze delle Immagini, Sezione di Clinica Ginecologica Ostetrica e di Fisiopatologia della Riproduzione Umana, Università degli Studi di Cagliari, Cagliari, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Floris
authors.forename: Bruno
authors.initials: B
authors.lastname: Piras
authors.forename: Marisa
authors.initials: M
authors.lastname: Orrù
authors.forename: Enrico
authors.initials: E
authors.lastname: Silvetti
authors.forename: Anna
authors.initials: A
authors.lastname: Tusconi
authors.forename: Francesca
authors.initials: F
authors.lastname: Melis
authors.forename: Milena
authors.initials: M
authors.lastname: Tuveri
authors.forename: Marco
authors.initials: M
authors.lastname: Piga
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Paoletti
authors.forename: Gian Benedetto
authors.initials: GB
authors.lastname: Melis
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D007275:Injections, Intravenous; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D015990:Placebo Effect; D014147:Tramadol / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol