title: Comparison of sublingual misoprostol with lidocaine spray for pain relief in office hysteroscopy: a randomized, double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  To compare the effectiveness of sublingual misoprostol with lidocaine pump spray for office hysteroscopy.
  
  
  METHODS
  Premenopausal women who had an indication for office hysteroscopy were included in this randomized, double-blind, placebo-controlled study. Eighty-two patients were evaluable for the final analysis.
  
  
  METHODS
  A tertiary referral center.
  
  
  METHODS
  Premenopausal women who had an indication for office hysteroscopy were included. Eighty-two patients were evaluable for the final analysis.
  
  
  METHODS
  Patients were randomized to receive either sublingual misoprostol and placebo of lidocaine or lidocaine pump spray applied to the cervix and placebo of misoprostol.
  
  
  RESULTS
  When compared with the lidocaine group, patients in the misoprostol group reported less pain by the immediate visual analog scale scores (2.2 ± 0.98 vs. 2.6 ± 0.99, p = .030), whereas visual analog scale scores at 10 minutes were similar between groups (2.1 ± 0.98 vs. 2.36 ± 1.06, p = .156).
  
  
  CONCLUSIONS
  Sublingual misoprostol is more effective than lidocaine spray in pain reduction during office hysteroscopy. Misoprostol may cause vaginal spotting, which may impair the vision during hysteroscopy especially just after the menstrual period. Preventive measures should be taken to make the procedure pain free because the physician may underestimate pain perception during the procedure.
authors.affiliation: Department of Obstetrics and Gynecology, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey. sertacesin@gmail.com
authors.forename: Sertac
authors.initials: S
authors.lastname: Esin
authors.forename: Eralp
authors.initials: E
authors.lastname: Baser
authors.forename: Erhan
authors.initials: E
authors.lastname: Okuyan
authors.forename: Tuncay
authors.initials: T
authors.lastname: Kucukozkan
mesh_terms: D000282:Administration, Intravaginal; D000286:Administration, Sublingual; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D016595:Misoprostol / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D059408:Pain Management / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local; D016595:Misoprostol; D008012:Lidocaine
keywords: Cervical dilatation; Lidocaine; Misoprostol; Office hysteroscopy