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Published on: August 2, 2024
Thermachoice endometrial ablation in the outpatient setting, without local anesthesia or intravenous sedation: a
Fiona Marsh1, Jenny Thewlis, Sean Duffy
1Academic Department of Obstetrics and Gynaecology, St. James's University Hospital, Leeds, United Kingdom. medfm@leeds.ac.uk
Objective:
To determine whether Thermachoice endometrial ablation (EA) is a safe and acceptable procedure when performed in the outpatient (OP) setting without local anesthesia or IV sedation.
Design:
Prospective cohort (double group) study.
Setting:
Hysteroscopy clinic of large UK hospital.
Patient(S):
Twenty-seven women with menorrhagia.
Intervention(S):
The first cohort of women underwent Thermachoice EA without elective analgesia. The second cohort underwent Thermachoice after taking ibuprofen.
Main Outcome Measure(S):
To map pain scores and the requirement of "rescue analgesia." To assess speed of recovery and time away from home.
Result(S):
Thermachoice EA was successfully performed in the OP setting on 89% (n = 24) of women. Four women in the first cohort required rescue analgesia compared to none in the second. During the procedure there was little difference between the groups visual analogue style pain scores-with the overall score being 3.6 (range = 0-10). Postoperatively there was a lower mean pain score in the second cohort, with fewer women experiencing nausea and vomiting. Mean time away from home was 2.6 hours and mean time to make a full recovery was 3.3 days. Women required analgesia for 2.6 days, on average, and returned to their normal activities at this time.
Conclusion(S):
Thermachoice EA without local analgesia or IV sedation can be safely and successfully performed in the OP setting and if ibuprofen is taken preoperatively few women require "rescue analgesia."
