الفهرس 
Comparison between the analgesic effect of lidocaine dissolved in distension medium and rectal diclofenac sodium during outpatient hysteroscopy
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Abstract
Background: Outpatient hysteroscopy is a clinical procedure that is used for several diagnostic and therapeutic purposes. However, the most common adverse event and reason for procedure failure is pain. Several strategies were developed to manage pain during outpatient hysteroscopy. Objectives The aim of this study was: (1)To assess the analgesic efficacy of lidocaine dissolved in the distension medium compared to rectal diclofenac sodium during anesthesia free diagnostic hysteroscopy. (2) To minimize diagnostic hysteroscopy cancellation due to associated pain. Study Design: This was a comparative randomized study conducted at Kasr Alainy Hospital in the outpatient hysteroscopy clinic from November 2018 to November 2019. One hundred nulliparous women who underwent diagnostic office hysteroscopy were randomly divided into 100mg rectal diclofenac group and 10ml of lidocaine 2% dissolved in 500ml saline group.The perception of pain was assessed during hysteroscope insertion, visualization of the uterine cavity and 30 minutes following the procedure using the Visual analogue scale (VAS).The patient was considered in pain with VAS {u2265} 4.Results: Intrauterine instillation of 10ml lidocaine 2% was inferior to100mg rectal diclofenac in reducing pain during office hysteroscopy insertion, uterine visualization and 30 minutes following the procedure, as proved statistically by significant difference (P value < 0.001). Both drugs were tolerable with no observed adverse events