A randomized controlled study comparing carbon dioxide versus normal saline as distension media in diagnostic office hysteroscopy: is the distension with carbon dioxide a problem?

作者：Raimondo Gennaro; Raimondo Diego; D'Aniello Gemma; Russo Cinzia; Ronga Antonietta; Gabbanini Massimo; Filippeschi Marco; Petraglia Felice; Florio Pasquale^*

来源：Fertility and Sterility, 2010, 94(6): 2319-2322.

DOI：10.1016/j.fertnstert.2009.11.041

• Carbon dioxide
• CO2
• normal saline
• pain
• office diagnostic hysteroscopy
• view

Objective: To compare two distension media, carbon dioxide (CO2) and saline, with regards to patient discomfort and the adequacy of the panoramic view in diagnostic hysteroscopy by the vaginoscopic approach.
Design: Randomized prospective study.
Setting: Tertiary referral centers for gynecologic care.
Patient(s): 264 patients randomly allocated to two groups: CO2 (132 women) and normal saline (132 women).
Intervention(s): Office hysteroscopy performed with a forward-oblique 30 degrees telescope (total diameter 5.1 mm) and CO2 as the distension medium or with a forward-oblique 30 degrees telescope (final diameter 5.1 mm) and saline solution as the distension medium.
Main Outcome Measure(s): Global operative time, pain experienced by patients using a visual analogue scale (VAS), severity of the pain (VAS), incidence of collateral effects (shoulder-tip pain, nausea, or dizziness), degree of difficulty, and view (VAS).
Result(s): Pelvic discomfort was comparable between groups, without statistically significant differences in intensity or degree of difficulty. However, the visual quality was statistically significantly higher when hysteroscopy was performed with CO2 a s the distension medium.
Conclusion(s): No relevant difference in pain or technical difficulty was found between the two distension media, but CO2 was associated with better quality visualization. (Fertil Steril (R) 2010;94:2319-22.

• 出版日期2010-11