Office hysteroscopy has become increasingly used as first line investigation for abnormal uterine bleeding and other diseases involving the uterine cavity. The main limitation to its widespread use is pain and low patient tolerance. This review examines current literature on analgesia used in outpatient hysteroscopy with the purpose of establishing guidelines on methods of pain relief for the procedure. However, the review has failed to find substantial or conclusive evidence for the routine use of local analgesia in outpatient hysteroscopy. Most literature suggests that it is a well-tolerated procedure and recommends analgesic use only in selected patients. Additional research is indicated for developing superior narrow diameter hysteroscopes and endometrial biopsy devices to improve the acceptability of office hysteroscopy.
Target Audience: Obstetricians & Gynecologists, Family Physicians
Learning Objectives: After completion of this article, the reader will be able to outline the various methods used for anesthesia in outpatient hysteroscopy, compare the efficacy of the various anesthetic methods, and list the features of the patient at high risk of experiencing pain during outpatient hysteroscopy.