Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
Second Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland.
Arch Gynecol Obstet. 2020 Apr;301(4):885-894. doi: 10.1007/s00404-020-05460-2. Epub 2020 Mar 5.
The aim of this review is to provide an overview of the literature about the perception and management of anxiety and pain in women undergoing an office hysteroscopic procedure.
We performed a systematic literature search in Embase, PubMed/MEDLINE, Cochrane Library and Web of Science for original studies written in English (registered in PROSPERO 2019-CRD42019132341), using the terms 'hysteroscopy' AND 'pain' AND 'anxiety' published up to January 2019. Only original articles (randomized, observational and retrospective studies) about management of anxiety and pain related to the hysteroscopic procedure were considered eligible.
Our literature search produced 84 records. After exclusions, 11 studies including 2222 patients showed the following results: (a) pain experienced during hysteroscopy is negatively affected by preprocedural anxiety; (b) pharmacological interventions seem to be help in reducing pain during hysteroscopy; (c) waiting time before the procedure is a significant factor affecting patients' anxiety; (d) music during the procedure may be helpful in reducing anxiety.
The utilization of office hysteroscopy is hampered by varying levels of anxiety and pain perceived by women who are candidates for the procedure. For these reasons, it is essential to identify effective pharmacological and non-pharmacological strategies to alleviate these factors. We recommend further studies especially focusing on non-pharmacological interventions to facilitate the dissemination of good clinical practices among hysteroscopists.
本综述旨在提供关于接受门诊宫腔镜检查的女性对焦虑和疼痛的感知和管理的文献综述。
我们在 Embase、PubMed/MEDLINE、Cochrane 图书馆和 Web of Science 中进行了系统的文献检索，使用了“宫腔镜”和“疼痛”和“焦虑”的术语，并检索了截至 2019 年 1 月发表的英文原始研究（在 PROSPERO 2019-CRD42019132341 中注册）。仅考虑与宫腔镜手术相关的焦虑和疼痛管理的原始文章（随机、观察和回顾性研究）符合入选标准。
我们的文献检索产生了 84 条记录。排除后，11 项研究包括 2222 名患者，结果如下：（a）宫腔镜检查过程中经历的疼痛受到术前焦虑的负面影响；（b）药物干预似乎有助于减轻宫腔镜检查过程中的疼痛；（c）手术前的等待时间是影响患者焦虑的重要因素；（d）手术过程中的音乐可能有助于减轻焦虑。
由于候选患者对焦虑和疼痛的感知程度不同，门诊宫腔镜检查的应用受到了阻碍。因此，确定有效的药物和非药物策略来缓解这些因素至关重要。我们建议进行进一步的研究，特别是关注非药物干预措施，以促进宫腔镜医师之间良好临床实践的传播。
