title: A systematic review of the effect of the distension medium on pain during outpatient hysteroscopy.
abstract: OBJECTIVE
  To assess the effect of distension medium on pain during outpatient hysteroscopy.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Outpatient hysteroscopy clinics.
  
  
  METHODS
  Women undergoing outpatient hysteroscopic examination.
  
  
  METHODS
  Use of normal saline versus carbon dioxide as distension medium for outpatient hysteroscopy.
  
  
  METHODS
  Pain scores.
  
  
  RESULTS
  There was no statistically significant difference in pain scores when carbon dioxide or normal saline were used as the distension medium for outpatient hysteroscopy (standardized mean differences=-0.05; 95% CI, -0.17 to 0.07; I2=92%).
  
  
  CONCLUSIONS
  Carbon dioxide and normal saline are both suitable distending media for outpatient hysteroscopy as the procedural pain is comparable and the views obtained are satisfactory. However, normal saline does confer advantages that may make it more suitable for clinical use.
authors.affiliation: Clinical and Experimental Medicine, University of Birmingham, Obstetrics-Gynaecology and Clinical Epidemiology, Birmingham Women's Hospital, Birmingham, United Kingdom.
authors.forename: Natalie A M
authors.initials: NA
authors.lastname: Cooper
authors.forename: Paul
authors.initials: P
authors.lastname: Smith
authors.forename: Khalid S
authors.initials: KS
authors.lastname: Khan
authors.forename: T Justin
authors.initials: TJ
authors.lastname: Clark
mesh_terms: D002245:Carbon Dioxide; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis*; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D010045:Outpatients; D010146:Pain / Q000209:etiology*; D012965:Sodium Chloride
chemical_list: D002245:Carbon Dioxide; D012965:Sodium Chloride