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Updated: May 4, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Identifying predictors of unacceptable pain at office hysteroscopy
Márlon de Freitas Fonseca1, Felipe V Sessa1, José Anacleto D Resende2
1Departments of Anesthesiology and Gynecology, Instituto Fernandes Figueira, Rio de Janeiro, Brazil.
Study Objective:
To identify predictors of unacceptable pain during office hysteroscopy without anesthesia.
Design:
Prospective observational study (Canadian Task Force classification II-2).
Setting:
Teaching hospital.
Patients:
Five hundred fifty-eight women aged 17 to 73 years.
Intervention:
Elective office hysteroscopy without anesthesia.
Measurements And Main Results:
Pain intensity was assessed via a verbal rating scale (VRS, 0-10). Pain was considered unacceptable when severe during the procedure (VRS ≥7) or moderate to severe at discharge (VRS ≥4). After preliminary statistical analysis, factors including diabetes, age ≤50 years, previous curettage, dyspareunia, severe dysmenorrhea, and hysteroscopist experience were selected to compose 2 binary multivariate models to predict unacceptable pain. As expected, hysteroscopist experience was protective against unacceptable pain during office hysteroscopy (p = .03; adjusted odds ratio [OR], 0.63; 95% confidence interval [CI], 41-96) and also at discharge (p = .002; adjusted OR, 0.48; 95% CI, 30-77). Severe dysmenorrhea was a significant risk factor for pain (cramps) at discharge (p < .001; adjusted OR, 3.07; 95% CI, 1.97-4.78).
Conclusion:
Women with severe dysmenorrhea will benefit from preemptive analgesia regardless of hysteroscopist level of experience because this condition significantly increased the occurrence of unacceptable cramps at discharge.
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