Comparison of pain and proper sample status according to usage of tenaculum and analgesia: a randomized clinical trial
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
ObjectiveColposcopic biopsy is a discomfortable procedure. Additionally, it creates negative influence on sexuality. This studyaimed to investigate the relationships among tenaculum, pain perception, and biopsy size during colposcopy. MethodsIn total, 228 patients who underwent colposcopy-directed biopsy were included, and randomized into 4 groups basedon whether analgesic and tenaculum were used and replaced (tenaculum with n=58/without analgesic n=56, notenaculum replacement with n=57/without analgesic n=57). Lidocaine hydrochloride (40 mg) plus adrenaline (0.025mg) was administered in the analgesic groups. The pain was assessed using a linear visual analog scale. The biopsyspecimen size was measured in millimeters. ResultsThe mean age of the patients was 42.85±8.88 years. The most frequent colposcopy indications were atypicalsquamous cells of undetermined significance and human papilloma virus-positive results on cervical cytology (30.2%;n=69). Low- and high-grade intraepithelial lesions were noted in 14.91% (n=34) and 10.96% (n=25) women throughcolposcopy-directed biopsy results, respectively. Tenaculum replacement increased pain perception in the withoutanalgesic group; however, no statistically significant differences were noted between of the groups with and withouttenaculum replacement with analgesic. The size and number of biopsy specimens were not associated with tenaculumreplacement and analgesic use. ConclusionAdministration of analgesics decreased discomfortand pain in patients. Tenaculum replacement aidedcolposcopists in manipulating the cervix. Additionally,administration of analgesics relieved pain in thetenaculum replacement group.
Abstract
ObjectiveColposcopic biopsy is a discomfortable procedure. Additionally, it creates negative influence on sexuality. This studyaimed to investigate the relationships among tenaculum, pain perception, and biopsy size during colposcopy. MethodsIn total, 228 patients who underwent colposcopy-directed biopsy were included, and randomized into 4 groups basedon whether analgesic and tenaculum were used and replaced (tenaculum with n=58/without analgesic n=56, notenaculum replacement with n=57/without analgesic n=57). Lidocaine hydrochloride (40 mg) plus adrenaline (0.025mg) was administered in the analgesic groups. The pain was assessed using a linear visual analog scale. The biopsyspecimen size was measured in millimeters. ResultsThe mean age of the patients was 42.85±8.88 years. The most frequent colposcopy indications were atypicalsquamous cells of undetermined significance and human papilloma virus-positive results on cervical cytology (30.2%;n=69). Low- and high-grade intraepithelial lesions were noted in 14.91% (n=34) and 10.96% (n=25) women throughcolposcopy-directed biopsy results, respectively. Tenaculum replacement increased pain perception in the withoutanalgesic group; however, no statistically significant differences were noted between of the groups with and withouttenaculum replacement with analgesic. The size and number of biopsy specimens were not associated with tenaculumreplacement and analgesic use. ConclusionAdministration of analgesics decreased discomfortand pain in patients. Tenaculum replacement aidedcolposcopists in manipulating the cervix. Additionally,administration of analgesics relieved pain in thetenaculum replacement group.
참고문헌 (29)
- King A, "The Papanicolaou smear", West J Med, 156, pp.202~204 (1992)
- Singer A, "Impact of introduction of colposcopy to a district general hospital", Br Med J(Clin Res Ed), 289, pp.1049~1051 (1984)
- Massad LS, "2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors", Obstet Gynecol, 121, pp.829~846 (2013)
- Campion MJ, "Psychosexual trauma of an abnormal cervical smear", Br J Obstet Gynaecol, 95, pp.175~181 (1988)
- Ideström M, "Women’s experience of coping with a positive Pap smear : a register-based study of women with two consecutive Pap smears reported as CIN 1", Acta Obstet Gynecol Scand, 82, pp.756~761 (2003)
- Kola-Palmer S, "Correlates of psychological distress immediately following colposcopy", Psychooncology, 24, pp.819~824 (2015)
- Waller J, "Women’s experiences of repeated HPV testing in the context of cervical cancer screening : a qualitative study", Psychooncology, 16, pp.196~204 (2007)
- Clifton PA, "Ineffectiveness of topical benzocaine spray during colposcopy", J Fam Pract, 46, pp.242~246 (1998)
- Schmid BC, "Forced coughing versus local anesthesia and pain associated with cervical biopsy : a randomized trial", Am J Obstet Gynecol, 199, pp.641~ (2008)
- Naki MM, "Analgesic efficacy of forced coughing versus local anesthesia during cervical punch biopsy", Gynecol Obstet Invest, 72, pp.5~9 (2011)
- Freeman SJ, "The revised FIGO staging system for uterine malignancies : implications for MR imaging", Radiographics, 32, pp.1805~1827 (2012)
- Bhatla N, "Cancer of the cervix uteri", Int J Gynaecol Obstet, 143(Suppl 2), pp.22~36 (2018)
- Gajjar K, "Pain relief for women with cervical intraepithelial neoplasia undergoing colposcopy treatment", Cochrane Database Syst Rev, 10, pp.CD006120~ (2012)
- Hilal Z, "Video colposcopy for reducing patient anxiety during colposcopy a randomized controlled trial", Obstet Gynecol, 130, pp.411~419 (2017)
- Galaal K, "Interventions for reducing anxiety in women undergoing colposcopy", Cochrane Database Syst Rev, 7, pp.CD006013~ (2011)
- Bosgraaf RP, "Qualitative insights into the psychological stress before and during colposcopy : a focus group study", J Psychosom Obstet Gynaecol, 34, pp.150~156 (2013)
- Tsao JC, "Long-term effects of a brief distraction intervention on children’s laboratory pain reactivity", Behav Modif, 27, pp.217~232 (2003)
- Dickenson AH, "Gate control theory of pain stands the test of time", Br J Anaesth, 88, pp.755~757 (2002)
- Bogani G, "Local anesthetic versus forced coughing at colposcopic-guided biopsy : a prospective study", Eur J Obstet Gynecol Reprod Biol, 181, pp.15~19 (2014)
- Öz M, "Comparison of topical lidocaine spray with placebo for pain relief in colposcopic procedures : a randomized, placebo-controlled, double-blind study", J Low Genit Tract Dis, 19, pp.212~214 (2015)
- Rabin JM, "Topical anesthesia for gynecologic procedures", Obstet Gynecol, 73, pp.1040~1044 (1989)
- Chan YM, "The use of music to reduce anxiety for patients undergoing colposcopy : a randomized trial", Gynecol Oncol, 91, pp.213~217 (2003)
- Walsh JC, "Anxiety levels in women attending a colposcopy clinic : a randomised trial of an educational intervention using video colposcopy", Patient Educ Couns, 55, pp.247~251 (2004)
- Kola-Palmer S, "Patients’ perceptions of colposcopy pain", Eur J Cancer Care(Engl), 25, pp.49~56 (2016)
- Johnson N, "Effect of cervical traction with a tenaculum on the uterocervical angle", Br J Obstet Gynaecol, 98, pp.309~312 (1991)
- Goldthwaite LM, "Comparison of interventions for pain control with tenaculum placement : a randomized clinical trial", Contraception, 89, pp.229~233 (2014)
- Robinson RD, "Intracervical block and pain perception during the performance of a hysterosalpingogram : a randomized controlled trial", Obstet Gynecol, 109, pp.89~93 (2007)
- Oyama IA, "Local anesthetic reduces the pain of colposcopic biopsies : a randomized trial", Am J Obstet Gynecol, 188, pp.1164~1165 (2003)
- Kiviharju M, "Pain sensation during colposcopy and cervical biopsy, with or without local anesthesia : a randomized trial", J Low Genit Tract Dis, 21, pp.102~107 (2017)