Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Fertil Steril. 2019 Jul;112(1):140-148.e12. doi: 10.1016/j.fertnstert.2019.03.028. Epub 2019 May 2.
To determine the most effective analgesia for pain relief during the outpatient endometrial biopsy (OEB) or outpatient hysteroscopy with endometrial aspiration (EA).
Systematic review and network meta-analysis of randomized controlled trials.
Not applicable.
PATIENT(S): Pre- or postmenopausal women undergoing OEB or outpatient hysteroscopy with EA for evaluation of uterine pathology.
INTERVENTION(S): We conducted an electronic search of the following bibliographic databases: Medline via PubMed, SCOPUS, Web of Science, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL).
MAIN OUTCOME MEASURE(S): The intensity of pain during, immediately after, and 10-30 minutes after procedure assessed by the 10-cm visual analog scale.
RESULT(S): Lidocaine spray was the most effective medication for reducing pain during OEB (P-score = 0.83) and immediately after OEB (P-score = 0.96). On the other hand, naproxen sodium was the most effective medication for reducing pain during outpatient hysteroscopy with EA (P-score = 1.00), followed by misoprostol plus lidocaine (P-score = 0.87).
CONCLUSION(S): Lidocaine spray, either alone or with topical application of lidocaine, is the most effective medication for reducing the pain during and after the OEB. Naproxen sodium is the most effective analgesic option during outpatient hysteroscopy with EA.
确定门诊子宫内膜活检（OEB）或门诊宫腔镜子宫内膜吸引术（EA）期间缓解疼痛的最有效镇痛方法。
系统评价和网络荟萃分析的随机对照试验。
不适用。
接受 OEB 或门诊宫腔镜 EA 以评估子宫病理学的绝经前或绝经后妇女。
我们对以下文献数据库进行了电子检索：Medline 通过 PubMed、SCOPUS、Web of Science、ClinicalTrials.gov 和 Cochrane 对照试验中心注册库（CENTRAL）。
通过 10 厘米视觉模拟评分评估手术期间、手术结束即刻和 10-30 分钟时的疼痛强度。
利多卡因喷雾是减轻 OEB 期间疼痛的最有效药物（P 评分 = 0.83）和 OEB 后即刻疼痛（P 评分 = 0.96）。另一方面，萘普生钠是减轻门诊宫腔镜 EA 期间疼痛的最有效药物（P 评分 = 1.00），其次是米索前列醇加利多卡因（P 评分 = 0.87）。
利多卡因喷雾，无论是单独使用还是局部应用利多卡因，都是减轻 OEB 期间和之后疼痛的最有效药物。萘普生钠是门诊宫腔镜 EA 期间最有效的镇痛选择。
