Marbin Staci J, Baez Adriana, Carugno Jose A, Lindheim Steven R
Resident Physician.
Medical Student.
Obstet Gynecol Surv. 2025 May;80(5):307-314. doi: 10.1097/OGX.0000000000001387.
Despite the known advantages and incentives for providers and patients, reticence to performing office hysteroscopy remains due to provider inexperience, challenges to adequate pain management, and greater comfort level in the operating room setting. The relatively low utilization across the field of gynecology necessitates a deeper understanding of essential elements of hysteroscopy and the shared skills gained by experience.
This review serves to aid providers in optimizing periprocedural patient experience and procedural outcomes during in-office hysteroscopy.
A comprehensive literature review was conducted to evaluate nonpharmacologic approaches to pain and anxiety management during in-office hysteroscopy. PubMed, Scopus, and Cochrane Library databases were searched for peer-reviewed articles published in English. Search terms included combinations of "in-office hysteroscopy," "pain management," "anxiety management," "non-pharmacologic," communication," and "office set-up." Additional references were identified from citations within relevant articles. Studies were selected based on relevance, focusing on randomized controlled trials, systematic reviews, meta-analyses, and observational studies. Findings were synthesized to provide a comprehensive overview of current evidence and highlight areas for future research.
Nuanced approaches to pain and anxiety management during in-office hysteroscopy identified include virtual reality, music, hypnosis, and transcutaneous nerve stimulation. Simple strategies such as optimizing office setup while utilizing the newest technological advances and effective communication were identified as ways to alleviate patient discomfort and increase procedure acceptability.
An understanding of the basic elements of in-office hysteroscopy will benefit patients and providers alike, aiding the transition out of the operating room and into the office setting.
尽管宫腔镜检查对医护人员和患者有诸多已知的优势和激励措施，但由于医护人员缺乏经验、充分的疼痛管理面临挑战以及在手术室环境中更舒适，宫腔镜检查在门诊的应用仍存在阻力。妇科领域相对较低的利用率需要对宫腔镜检查的基本要素以及经验积累所获得的共同技能有更深入的了解。
本综述旨在帮助医护人员在门诊宫腔镜检查期间优化围手术期患者体验和手术效果。
进行了全面的文献综述，以评估门诊宫腔镜检查期间疼痛和焦虑管理的非药物方法。在PubMed、Scopus和Cochrane图书馆数据库中搜索以英文发表的同行评审文章。搜索词包括“门诊宫腔镜检查”、“疼痛管理”、“焦虑管理”、“非药物”、“沟通”和“门诊设置”的组合。从相关文章的参考文献中识别出其他参考文献。根据相关性选择研究，重点关注随机对照试验、系统评价、荟萃分析和观察性研究。对研究结果进行综合，以全面概述当前证据并突出未来研究领域。
确定的门诊宫腔镜检查期间疼痛和焦虑管理的细微差别方法包括虚拟现实、音乐、催眠和经皮神经刺激。一些简单的策略，如在利用最新技术进步的同时优化门诊设置以及进行有效的沟通，被认为是减轻患者不适和提高手术可接受性的方法。
了解门诊宫腔镜检查的基本要素将使患者和医护人员都受益，有助于从手术室过渡到门诊环境。
