Rutgers New Jersey Medical School, Newark, NJ.
Rutgers University School of Public Health, Piscataway, NJ.
J Low Genit Tract Dis. 2020 Apr;24(2):211-214. doi: 10.1097/LGT.0000000000000517.
The aim of the study was to determine whether forced cough during colposcopy-guided cervical biopsy affected pain and anxiety levels.
The study was conducted at the University Hospital (Newark, NJ) Ambulatory Care Center from December 2016 to June 2018 and evaluated 110 patients at the time of a colposcopy-guided cervical biopsy. Study patients were randomized to either cough or no cough group during the biopsy procedure. Pain level was assessed using a visual analog pain scale before, during, and immediately after a colposcopy-guided cervical biopsy. Study patients also completed a standardized anxiety survey before and after the procedure. T tests, Pearson χ, or Cochran-Mantel-Haenszel were used to compare baseline characteristics between the cough and no cough groups. Multivariate linear regression analysis was used to identify potential confounders and then compare pain levels across both groups.
There was no statistically significant difference in pain scores between the cough and no cough group when analyzed for each demographic variable even when confounders were accounted for. The anxiety scores for both study groups before and after the procedure were similar and not significantly reduced.
We observed a trend that cough reduced pain associated with the colposcopy-guided cervical biopsy but did not reach statistical significance. A similar outcome was observed in anxiety level, where anxiety was reduced in the cough group but was not statistically significant as compared with the no cough group. Further studies are necessary to assess various modalities in reducing pain and anxiety associated with colposcopy-guided cervical biopsy.
本研究旨在确定阴道镜引导下宫颈活检时强迫性咳嗽是否会影响疼痛和焦虑水平。
本研究于 2016 年 12 月至 2018 年 6 月在纽瓦克大学医院（新泽西州）门诊中心进行，评估了 110 例阴道镜引导下宫颈活检患者。研究患者在活检过程中随机分为咳嗽组或不咳嗽组。使用视觉模拟疼痛量表在阴道镜引导下宫颈活检前、中、后评估疼痛水平。研究患者还在术前和术后完成了标准化焦虑调查。使用 t 检验、Pearson χ检验或 Cochran-Mantel-Haenszel 检验比较咳嗽组和不咳嗽组之间的基线特征。使用多元线性回归分析来确定潜在的混杂因素，然后比较两组之间的疼痛水平。
即使考虑了混杂因素，在分析每个人口统计学变量时，咳嗽组和不咳嗽组之间的疼痛评分均无统计学差异。两组患者术前和术后的焦虑评分相似，且无显著降低。
我们观察到一种趋势，即咳嗽可减轻与阴道镜引导下宫颈活检相关的疼痛，但未达到统计学意义。在焦虑水平方面也观察到类似的结果，咳嗽组的焦虑减轻，但与不咳嗽组相比无统计学意义。需要进一步研究以评估各种方法在减轻与阴道镜引导下宫颈活检相关的疼痛和焦虑方面的作用。
