Tolerability of hysteroscopy under local anaesthesia

To assess the tolerability of hysteroscopy amongst patients, when performed under local anesthesia. Patients attending the Outpatient Clinics with bleeding per vagina were randomly selected. After the clinical work-up and taking consent, all patients were given injection diclofenac sodium half an hour prior to the procedure. After preparing and positioning the patient,10cc of injection Bupivacaine was given for para cervical block at 3 and 9 o'clock positions. The uterine cavity was distended with normal saline. Hysteroscopy was performed and the findings noted. Pain scoring was done by visual analogue scale. The condition of the patient was monitored during and after the procedure; they were kept under observation for four hours. Tolerability of the procedure was assessed by pain scoring and the presence of complications, and the results analyzed. During the study period 113 patients underwent hysteroscopy for abnormal uterine bleeding. The procedure was performed successfully in 98.2% patients without any complications, while 1.8% patients experienced transient vasovagal attack. The procedure was painless in 52.2% patients; 40.7% patients had mild pain (score <3) and were reassured, whereas 7.1% patients had moderate pain (score 3-5). Only 3.5% cases required analgesia for pain control. All patients remained haemodynamically stable during and after the procedure. Hysteroscopy is very well tolerated under local anaesthesia by our local population. (author)