title: Pain Management for Gynecologic Procedures in the Office.
abstract: OBJECTIVE
  Satisfactory pain control for women undergoing office gynecologic procedures is critical for both patient comfort and procedure success. Therefore, it is important for clinicians to be aware of the safety and efficacy of different pain control regimens.
  
  
  OBJECTIVE
  This article aimed to review the literature regarding pain control regimens for procedures such as endometrial biopsy, intrauterine device insertion, colposcopy and loop electrosurgical excisional procedure, uterine aspiration, and hysteroscopy.
  
  
  METHODS
  A search of published literature using PubMed was conducted using the following keywords: "pain" or "anesthesia." These terms were paired with the following keywords: "intrauterine device" or "IUD," "endometrial biopsy," "uterine aspiration" or "abortion," "colposcopy" or "loop electrosurgical excisional procedure" or "LEEP," "hysteroscopy" or "hysteroscopic sterilization." The search was conducted through July 2015. Articles were hand reviewed and selected by the authors for study quality. Meta-analyses and randomized controlled trials were prioritized.
  
  
  RESULTS
  Although local anesthesia is commonly used for gynecologic procedures, a multimodal approach may be more effective including oral medication, a dedicated emotional support person, and visual or auditory distraction. Women who are nulliparous, are postmenopausal, have a history of dysmenorrhea, or suffer from anxiety are more likely to experience greater pain with gynecologic procedures. Evidence for some interventions exists; however, the interpretation of intervention comparisons is limited by the use of different regimens, pain measurement scales, patient populations, and procedure techniques.
  
  
  CONCLUSIONS
  There are many options for pain management for office gynecologic procedures, and depending on the procedure, different modalities may work best. The importance of patient counseling and selection cannot be overstated.
authors.affiliation: Assistant Professor of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA.
authors.forename: Luu Doan
authors.initials: LD
authors.lastname: Ireland
authors.affiliation: Assistant Professor of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI.
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Allen
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control* / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement; D058748:Pain Perception
chemical_list: D000779:Anesthetics, Local