Cochrane · systematic review · CD007710
Pain relief for outpatient hysteroscopy
Ahmad, G, Saluja, S, O'Flynn, H, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
Gynaecology and FertilityAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
24
current version
GRADE rated
21
No studies
3
Included studies
NR
No studies 3 · 12.5%Ungraded 0 · 0%Very low 11 · 45.8%Low 10 · 41.7%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Local anaesthetic compared to placebo or no treatment for outpatient hysteroscopy
Population: women undergoing outpatient hysteroscopy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain score during procedure Local anaesthetic vs placebo or no treatment | no estimate extracted | 10 studies · 1496 participants | Low Downgraded: risk of bias, inconsistency |
Pain score within 30 min of procedure Local anaesthetic vs placebo or no treatment | no estimate extracted | 5 studies · 545 participants | Low Downgraded: risk of bias |
Pain score more than 30 min after procedure Local anaesthetic vs placebo or no treatment | no estimate extracted | 4 studies · 450 participants | Low Downgraded: risk of bias, imprecision |
Vasovagal reaction Local anaesthetic vs placebo or no treatment | OR 0.7 [0.43, 1.13] | 8 studies · 1309 participants | Very low Downgraded: risk of bias, imprecision |
Non‐pelvic pain Local anaesthetic vs placebo or no treatment | OR 1.76 [0.53, 5.8] | 1 study · 99 participants | Very low Downgraded: risk of bias |
Oral NSAID compared to placebo or no treatment for outpatient hysteroscopy
Population: women undergoing outpatient hysteroscopy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain score during procedure Oral NSAID vs placebo or no treatment | no estimate extracted | 3 studies · 521 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Pain score within 30 min of procedure Oral NSAID vs placebo or no treatment | no estimate extracted | 2 studies · 340 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Pain score more than 30 min after procedure Oral NSAID vs placebo or no treatment | no estimate extracted | 2 studies · 321 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Vasovagal reaction Oral NSAID vs placebo or no treatment | OR 0.76 [0.2, 2.94] | 1 study · 181 participants | Very low Downgraded: risk of bias, imprecision |
Non pelvic pain Oral NSAID vs placebo or no treatment | OR 2.93 [0.12, 72.99] | 1 study · 181 participants | Very low Downgraded: risk of bias, imprecision |
Allergic reaction Oral NSAID vs placebo or no treatment | OR 2.93 [0.12, 72.99] | 1 study · 181 participants | Very low Downgraded: risk of bias, imprecision |
Opioid compared to placebo or no treatment for outpatient hysteroscopy
Population: women undergoing outpatient hysteroscopy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain score during procedure: oral opioid Opioid vs placebo or no treatment | no estimate extracted | 1 study · 140 participants | Low Downgraded: risk of bias, inconsistency |
Pain score during procedure: sublingual opioid Opioid vs placebo or no treatment | no estimate extracted | 1 study · 164 participants | Low Downgraded: risk of bias, inconsistency |
Pain score within 30 min of procedure oral opioid Opioid vs placebo or no treatment | no estimate extracted | 1 study · 140 participants | Low Downgraded: risk of bias, inconsistency |
Pain score more than 30 min after procedure oral opioid Opioid vs placebo or no treatment | no estimate extracted | 1 study · 140 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Nausea and vomiting sublingual opioid Opioid vs placebo or no treatment | OR 107.55 [6.44, 1796.46] | 1 study · 164 participants | Low Downgraded: risk of bias |
Intracervical versus combined intracervical and paracervical anaesthesia
Population: women undergoing outpatient hysteroscopy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain score during procedure Intracervical vs combined intracervical and paracervical anaesthesia | no estimate extracted | 1 study · 84 participants | Very low Downgraded: risk of bias, imprecision |
Pain score within 30 minutes of the procedure Intracervical vs combined intracervical and paracervical anaesthesia | no estimate extracted | 1 study · 84 participants | Very low Downgraded: risk of bias, imprecision |
Pain score more than 30 minutes of the procedure Intracervical vs combined intracervical and paracervical anaesthesia | no estimate extracted | 1 study · 84 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effects Intracervical vs combined intracervical and paracervical anaesthesia | no estimate extracted | NR | No studies |
Antispasmodic plus NSAID versus paracervical anaesthesia
Population: women undergoing outpatient hysteroscopy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain score during procedure Antispasmodic plus NSAID vs paracervical anaesthesia | no estimate extracted | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |
Pain score within 30 minutes of the procedure Antispasmodic plus NSAID vs paracervical anaesthesia | no estimate extracted | NR | No studies |
Pain score more than 30 minutes after the procedure Antispasmodic plus NSAID vs paracervical anaesthesia | no estimate extracted | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effects Antispasmodic plus NSAID vs paracervical anaesthesia | no estimate extracted | NR | No studies |