Produção Nacional
Revisado por pares
Identifying Predictors of Unacceptable Pain at Office Hysteroscopy
2014; Elsevier BV; Volume: 21; Issue: 4 Linguagem: Inglês
10.1016/j.jmig.2013.12.118
ISSN1553-4669
AutoresMárlon de Freitas Fonseca, Felipe Ventura Sessa, José Anacleto Dutra de Resende Júnior, Camilla Gabriely Souza Guerra, Claudio Moura de Andrade, Claudio Peixoto Crispi,
Tópico(s)Pelvic floor disorders treatments
ResumoStudy Objective To identify predictors of unacceptable pain during office hysteroscopy without anesthesia. Design Prospective observational study (Canadian Task Force classification II-2). Setting Teaching hospital. Patients Five hundred fifty-eight women aged 17 to 73 years. Intervention Elective office hysteroscopy without anesthesia. Measurements and Main Results Pain intensity was assessed via a verbal rating scale (VRS, 0–10). Pain was considered unacceptable when severe during the procedure (VRS ≥7) or moderate to severe at discharge (VRS ≥4). After preliminary statistical analysis, factors including diabetes, age ≤50 years, previous curettage, dyspareunia, severe dysmenorrhea, and hysteroscopist experience were selected to compose 2 binary multivariate models to predict unacceptable pain. As expected, hysteroscopist experience was protective against unacceptable pain during office hysteroscopy (p = .03; adjusted odds ratio [OR], 0.63; 95% confidence interval [CI], 41–96) and also at discharge (p = .002; adjusted OR, 0.48; 95% CI, 30–77). Severe dysmenorrhea was a significant risk factor for pain (cramps) at discharge (p < .001; adjusted OR, 3.07; 95% CI, 1.97–4.78). Conclusion Women with severe dysmenorrhea will benefit from preemptive analgesia regardless of hysteroscopist level of experience because this condition significantly increased the occurrence of unacceptable cramps at discharge.
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