Nitrous oxide versus lidocaine versus no analgesic for in‐office hysteroscopy: a randomised clinical trial
Objective To compare the effect of inhaled nitrous oxide (INO) on pain control during in‐office hysteroscopy with 1% lidocaine paracervical infiltration and no analgesic. Design Single‐blind stratified randomised clinical trial with masked assessment by a third party. Setting Department of Obstetric...
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| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology 2021-07, Vol.128 (8), p.1364-1372 |
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| container_title | BJOG : an international journal of obstetrics and gynaecology |
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| creator | Solano Calvo, JA Valle Rubido, C Rodríguez‐Miguel, A Abajo, FJ Delgado Espeja, JJ González Hinojosa, J Fernández Muñoz, L Zapico Goñi, Á |
| description | Objective
To compare the effect of inhaled nitrous oxide (INO) on pain control during in‐office hysteroscopy with 1% lidocaine paracervical infiltration and no analgesic.
Design
Single‐blind stratified randomised clinical trial with masked assessment by a third party.
Setting
Department of Obstetrics and Gynaecology in a Spanish hospital.
Population
Women who underwent hysteroscopy.
Methods
Patients were stratified into three groups according to the purpose of the hysteroscopy (biopsy, polypectomy or tubal sterilisation) and then assigned to different treatment groups through a permuted‐blocks randomisation within strata. Pain scale was provided by a gynaecologist totally blinded to procedures and treatments. Effects were assessed using a one‐way analysis of variance following an intention‐to‐treat approach.
Main outcome measures
Visual analogue scale (VAS) from 0 to 100 mm.
Results
A total of 314 women were included: 105 to INO, 104 to 1% lidocaine and 105 to no analgesic. Baseline characteristics were comparable. Mean VAS score after the procedure was 34.7 ± 25.8 mm, 36.1 ± 22.9 mm (P = 1.0) and 47.3 ± 28.2 mm (P = 0.001) for INO, 1% lidocaine and no analgesic, respectively. No adverse events were reported in 91 (86.7%) patients in the INO group compared with 79 (76%) in the 1%‐lidocaine group (P = 0.04) and 85 (81%) in the no‐analgesic group (P = 0.26).
Conclusion
INO was as effective as 1% lidocaine in pain control for in‐office hysteroscopy and was better tolerated. The no‐analgesic group presented the poorer results, so was the least recommended clinical option. |
| doi_str_mv | 10.1111/1471-0528.16657 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2485517189</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2485517189</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3717-129002c4cd205343f1fd821d90dff242ac9f715c6a1e3f4e69f64655441af19a3</originalsourceid><addsrcrecordid>eNqFkctOWzEQhq2KigTKurvKEhs2h3h8O-d0VxCXVgg27dpyfQFHznFqJ0B2fQSesU-CQ2gWbPBm7NE3v_z_g9BnIMdQzwR4Cw0RtDsGKUX7AY23nZ2XO2kIo90I7ZUyJQQkJWwXjRirQCfpGMXrsMhpWXB6DNbhe5dLfcRgk9Fh2DaGhPWg460rwWCfMg7Dv79PyftgHL5blYXLqZg0X33FGmc92DQLxVlsYhiC0REvctDxE_rodSzu4LXuo1_nZz9PL5urm4vvp9-uGsNaaBugPSHUcGMpEYwzD952FGxPrPeUU21634IwUoNjnjvZe8mlEJyD9tBrto-ONrrznP4sXVmo-hvjYtSDq14V5Z0Q0ELXV_TwDTpNy1ytVkpwIvuOtKJSkw1lqs2SnVfzHGY6rxQQtV6EWseu1rGrl0XUiS-vusvfM2e3_P_kKyA2wEOIbvWenjr5cbMRfgYMvZNu</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2540698075</pqid></control><display><type>article</type><title>Nitrous oxide versus lidocaine versus no analgesic for in‐office hysteroscopy: a randomised clinical trial</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Solano Calvo, JA ; Valle Rubido, C ; Rodríguez‐Miguel, A ; Abajo, FJ ; Delgado Espeja, JJ ; González Hinojosa, J ; Fernández Muñoz, L ; Zapico Goñi, Á</creator><creatorcontrib>Solano Calvo, JA ; Valle Rubido, C ; Rodríguez‐Miguel, A ; Abajo, FJ ; Delgado Espeja, JJ ; González Hinojosa, J ; Fernández Muñoz, L ; Zapico Goñi, Á</creatorcontrib><description>Objective
To compare the effect of inhaled nitrous oxide (INO) on pain control during in‐office hysteroscopy with 1% lidocaine paracervical infiltration and no analgesic.
Design
Single‐blind stratified randomised clinical trial with masked assessment by a third party.
Setting
Department of Obstetrics and Gynaecology in a Spanish hospital.
Population
Women who underwent hysteroscopy.
Methods
Patients were stratified into three groups according to the purpose of the hysteroscopy (biopsy, polypectomy or tubal sterilisation) and then assigned to different treatment groups through a permuted‐blocks randomisation within strata. Pain scale was provided by a gynaecologist totally blinded to procedures and treatments. Effects were assessed using a one‐way analysis of variance following an intention‐to‐treat approach.
Main outcome measures
Visual analogue scale (VAS) from 0 to 100 mm.
Results
A total of 314 women were included: 105 to INO, 104 to 1% lidocaine and 105 to no analgesic. Baseline characteristics were comparable. Mean VAS score after the procedure was 34.7 ± 25.8 mm, 36.1 ± 22.9 mm (P = 1.0) and 47.3 ± 28.2 mm (P = 0.001) for INO, 1% lidocaine and no analgesic, respectively. No adverse events were reported in 91 (86.7%) patients in the INO group compared with 79 (76%) in the 1%‐lidocaine group (P = 0.04) and 85 (81%) in the no‐analgesic group (P = 0.26).
Conclusion
INO was as effective as 1% lidocaine in pain control for in‐office hysteroscopy and was better tolerated. The no‐analgesic group presented the poorer results, so was the least recommended clinical option.</description><identifier>ISSN: 1470-0328</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/1471-0528.16657</identifier><identifier>PMID: 33528862</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adverse events ; Analgesia ; Analgesics ; Biopsy ; Clinical trials ; hysteroscopy ; Lidocaine ; Nitrous oxide ; Obstetrics ; Pain ; Patients ; Reproductive sterilization ; Womens health</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2021-07, Vol.128 (8), p.1364-1372</ispartof><rights>2021 John Wiley & Sons Ltd.</rights><rights>Copyright © 2021 Royal College of Obstetricians and Gynaecologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3717-129002c4cd205343f1fd821d90dff242ac9f715c6a1e3f4e69f64655441af19a3</citedby><cites>FETCH-LOGICAL-c3717-129002c4cd205343f1fd821d90dff242ac9f715c6a1e3f4e69f64655441af19a3</cites><orcidid>0000-0002-7026-9780</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1471-0528.16657$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1471-0528.16657$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33528862$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Solano Calvo, JA</creatorcontrib><creatorcontrib>Valle Rubido, C</creatorcontrib><creatorcontrib>Rodríguez‐Miguel, A</creatorcontrib><creatorcontrib>Abajo, FJ</creatorcontrib><creatorcontrib>Delgado Espeja, JJ</creatorcontrib><creatorcontrib>González Hinojosa, J</creatorcontrib><creatorcontrib>Fernández Muñoz, L</creatorcontrib><creatorcontrib>Zapico Goñi, Á</creatorcontrib><title>Nitrous oxide versus lidocaine versus no analgesic for in‐office hysteroscopy: a randomised clinical trial</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>Objective
To compare the effect of inhaled nitrous oxide (INO) on pain control during in‐office hysteroscopy with 1% lidocaine paracervical infiltration and no analgesic.
Design
Single‐blind stratified randomised clinical trial with masked assessment by a third party.
Setting
Department of Obstetrics and Gynaecology in a Spanish hospital.
Population
Women who underwent hysteroscopy.
Methods
Patients were stratified into three groups according to the purpose of the hysteroscopy (biopsy, polypectomy or tubal sterilisation) and then assigned to different treatment groups through a permuted‐blocks randomisation within strata. Pain scale was provided by a gynaecologist totally blinded to procedures and treatments. Effects were assessed using a one‐way analysis of variance following an intention‐to‐treat approach.
Main outcome measures
Visual analogue scale (VAS) from 0 to 100 mm.
Results
A total of 314 women were included: 105 to INO, 104 to 1% lidocaine and 105 to no analgesic. Baseline characteristics were comparable. Mean VAS score after the procedure was 34.7 ± 25.8 mm, 36.1 ± 22.9 mm (P = 1.0) and 47.3 ± 28.2 mm (P = 0.001) for INO, 1% lidocaine and no analgesic, respectively. No adverse events were reported in 91 (86.7%) patients in the INO group compared with 79 (76%) in the 1%‐lidocaine group (P = 0.04) and 85 (81%) in the no‐analgesic group (P = 0.26).
Conclusion
INO was as effective as 1% lidocaine in pain control for in‐office hysteroscopy and was better tolerated. The no‐analgesic group presented the poorer results, so was the least recommended clinical option.</description><subject>Adverse events</subject><subject>Analgesia</subject><subject>Analgesics</subject><subject>Biopsy</subject><subject>Clinical trials</subject><subject>hysteroscopy</subject><subject>Lidocaine</subject><subject>Nitrous oxide</subject><subject>Obstetrics</subject><subject>Pain</subject><subject>Patients</subject><subject>Reproductive sterilization</subject><subject>Womens health</subject><issn>1470-0328</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNqFkctOWzEQhq2KigTKurvKEhs2h3h8O-d0VxCXVgg27dpyfQFHznFqJ0B2fQSesU-CQ2gWbPBm7NE3v_z_g9BnIMdQzwR4Cw0RtDsGKUX7AY23nZ2XO2kIo90I7ZUyJQQkJWwXjRirQCfpGMXrsMhpWXB6DNbhe5dLfcRgk9Fh2DaGhPWg460rwWCfMg7Dv79PyftgHL5blYXLqZg0X33FGmc92DQLxVlsYhiC0REvctDxE_rodSzu4LXuo1_nZz9PL5urm4vvp9-uGsNaaBugPSHUcGMpEYwzD952FGxPrPeUU21634IwUoNjnjvZe8mlEJyD9tBrto-ONrrznP4sXVmo-hvjYtSDq14V5Z0Q0ELXV_TwDTpNy1ytVkpwIvuOtKJSkw1lqs2SnVfzHGY6rxQQtV6EWseu1rGrl0XUiS-vusvfM2e3_P_kKyA2wEOIbvWenjr5cbMRfgYMvZNu</recordid><startdate>202107</startdate><enddate>202107</enddate><creator>Solano Calvo, JA</creator><creator>Valle Rubido, C</creator><creator>Rodríguez‐Miguel, A</creator><creator>Abajo, FJ</creator><creator>Delgado Espeja, JJ</creator><creator>González Hinojosa, J</creator><creator>Fernández Muñoz, L</creator><creator>Zapico Goñi, Á</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7026-9780</orcidid></search><sort><creationdate>202107</creationdate><title>Nitrous oxide versus lidocaine versus no analgesic for in‐office hysteroscopy: a randomised clinical trial</title><author>Solano Calvo, JA ; Valle Rubido, C ; Rodríguez‐Miguel, A ; Abajo, FJ ; Delgado Espeja, JJ ; González Hinojosa, J ; Fernández Muñoz, L ; Zapico Goñi, Á</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3717-129002c4cd205343f1fd821d90dff242ac9f715c6a1e3f4e69f64655441af19a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adverse events</topic><topic>Analgesia</topic><topic>Analgesics</topic><topic>Biopsy</topic><topic>Clinical trials</topic><topic>hysteroscopy</topic><topic>Lidocaine</topic><topic>Nitrous oxide</topic><topic>Obstetrics</topic><topic>Pain</topic><topic>Patients</topic><topic>Reproductive sterilization</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Solano Calvo, JA</creatorcontrib><creatorcontrib>Valle Rubido, C</creatorcontrib><creatorcontrib>Rodríguez‐Miguel, A</creatorcontrib><creatorcontrib>Abajo, FJ</creatorcontrib><creatorcontrib>Delgado Espeja, JJ</creatorcontrib><creatorcontrib>González Hinojosa, J</creatorcontrib><creatorcontrib>Fernández Muñoz, L</creatorcontrib><creatorcontrib>Zapico Goñi, Á</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Solano Calvo, JA</au><au>Valle Rubido, C</au><au>Rodríguez‐Miguel, A</au><au>Abajo, FJ</au><au>Delgado Espeja, JJ</au><au>González Hinojosa, J</au><au>Fernández Muñoz, L</au><au>Zapico Goñi, Á</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nitrous oxide versus lidocaine versus no analgesic for in‐office hysteroscopy: a randomised clinical trial</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2021-07</date><risdate>2021</risdate><volume>128</volume><issue>8</issue><spage>1364</spage><epage>1372</epage><pages>1364-1372</pages><issn>1470-0328</issn><eissn>1471-0528</eissn><abstract>Objective
To compare the effect of inhaled nitrous oxide (INO) on pain control during in‐office hysteroscopy with 1% lidocaine paracervical infiltration and no analgesic.
Design
Single‐blind stratified randomised clinical trial with masked assessment by a third party.
Setting
Department of Obstetrics and Gynaecology in a Spanish hospital.
Population
Women who underwent hysteroscopy.
Methods
Patients were stratified into three groups according to the purpose of the hysteroscopy (biopsy, polypectomy or tubal sterilisation) and then assigned to different treatment groups through a permuted‐blocks randomisation within strata. Pain scale was provided by a gynaecologist totally blinded to procedures and treatments. Effects were assessed using a one‐way analysis of variance following an intention‐to‐treat approach.
Main outcome measures
Visual analogue scale (VAS) from 0 to 100 mm.
Results
A total of 314 women were included: 105 to INO, 104 to 1% lidocaine and 105 to no analgesic. Baseline characteristics were comparable. Mean VAS score after the procedure was 34.7 ± 25.8 mm, 36.1 ± 22.9 mm (P = 1.0) and 47.3 ± 28.2 mm (P = 0.001) for INO, 1% lidocaine and no analgesic, respectively. No adverse events were reported in 91 (86.7%) patients in the INO group compared with 79 (76%) in the 1%‐lidocaine group (P = 0.04) and 85 (81%) in the no‐analgesic group (P = 0.26).
Conclusion
INO was as effective as 1% lidocaine in pain control for in‐office hysteroscopy and was better tolerated. The no‐analgesic group presented the poorer results, so was the least recommended clinical option.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33528862</pmid><doi>10.1111/1471-0528.16657</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7026-9780</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1470-0328 |
| ispartof | BJOG : an international journal of obstetrics and gynaecology, 2021-07, Vol.128 (8), p.1364-1372 |
| issn | 1470-0328 1471-0528 |
| language | eng |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Adverse events Analgesia Analgesics Biopsy Clinical trials hysteroscopy Lidocaine Nitrous oxide Obstetrics Pain Patients Reproductive sterilization Womens health |
| title | Nitrous oxide versus lidocaine versus no analgesic for in‐office hysteroscopy: a randomised clinical trial |
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