Impact of anxiety levels on the perception of pain in patients undergoing office hysteroscopy
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GENERAL GYNECOLOGY
Impact of anxiety levels on the perception of pain in patients undergoing office hysteroscopy Felice Sorrentino1 · Annamaria Petito2 · Stefano Angioni3 · Francesco D’Antonio1 · Melania Severo2 · Maria Cristina Solazzo1 · Raffaele Tinelli4 · Luigi Nappi1 Received: 19 April 2020 / Accepted: 5 November 2020 © The Author(s) 2020
Abstract Objective This study aimed at assessing the impact of anxiety on pain perception during hysteroscopy and to highlight the possible contribution of factors related to pain perception. Materials and methods 104 women with indication for office hysteroscopy fullfilled anonymous self-report questionnaires during the waiting time, before the procedure. The first self-report questionnaire included general patient information and an overall assessment of the degree of satisfaction with the information received before the procedure. The level of preprocedural anxiety was measured through the State-Trait Anxiety Inventory STAI-Y1 (state anxiety). The perceived stress was assessed using the Perceived Stress Scale (PSS). The intensity of pain during the procedure and 20 min later was assessed with VAS score. Results The average waiting time was of 192.33 ± 91 min. 59 patients (56.7%) performed the examination without analgesia while 45 women (43.3%) required analgesia. 28 women (27%) experienced mild pain, 34 (33%) moderate pain and 42 (40%) severe pain. The patients who performed the procedure without analgosedation had an average STAI-Y1 score of 44.81 ± 1.20, compared to women who required analgosedation (average score of 49.40 ± 1.64). The perceived level of stress was also associated with the use of analgosedation. Patients who did not request any anesthetic intervention obtained a PSS average score of 16.66 ± 0.75, compared to the subgroup with anesthesia (score of 19.76 ± 0.90). Conclusions Anxiety represents a key element for the success of ambulatory hysteroscopy. The management of anxiety can reduce the request for analgesia with a consequent optimization of time, costs and safety. Keywords Hysteroscopy · Pain · Anxiety · Stress · VAS
Introduction The development of hysteroscopy has provided a minimally invasive approach to common gynecologic problems. Increased clinician training, smaller diameter hysteroscopes * Felice Sorrentino [email protected] 1
Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Viale L. Pinto, 71100 Foggia, Italy
2
Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
3
Department of Surgical Science, University of Cagliari, Monserrato, Italy
4
Department of Obstetrics and Gynecology, “Perrino” Hospital, Brindisi, Italy
and increased emphasis on office-based procedures have led to a widespread use of this important technology. Hysteroscopy is an endoscopic procedure that allows direct visualization of the uterine cavity and has become the gold- standard in the diagnosis and treatment of many gynecological pathological cond
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