Abstract

CANOVAS, L. et al. Analgesic efficacy of transmucosal fentanyl for hysteroscopies. Rev. Soc. Esp. Dolor [online]. 2006, vol.13, n.8, pp.533-537. ISSN 1134-8046.

Background: The aim of this study was to evaluate the effectiveness of the OTFC as analgesic, sedative and anxiolytic in patients who undergo diagnostic and therapeutic hysteroscopy. Methods: We carried out a prospective study in 40 patients who were programmed for diagnostic and therapeutic hysteroscopy. The inclusion’s criteria were: Patients with ASA I y II and who were nil by mouth for 8 hours. The exclusion’s criteria were: pregnancy and ASA > 3. None of the patients consumed antidepressants and/or anxiolytics. The patients were divided en 2 groups. Group A (n =20), patients planned for undergo diagnostic hysteroscopy received OTFC 20 minutes before surgery. The doses administrated were 200 μg. In those patients in which the diagnostic procedure was converted to the therapeutic, and the doses were insufficient an other dose of 200 μg was given 30 minutes after the first one. Group B (n = 20), patients planned for therapeutic hysteroscopy received 400 μg, 20 minutes before the procedure. In those patients in which we consider that the initial dose was insufficient, we given them a second dose of 200 μg 30 minutes after the first one. It was studied: 1. Blood pressure, heart rate and oxygen saturation, every 10 minutes from the premedication up to the discharge. 2. Level of analgesia, sedation and anxiety from the premedication up to the discharge. 3. Times between premedication up to the discharge. 4. Side effects. 5. Satisfaction of the patients: bad, regular, good and excellent. To evaluate the pain, we used a scale from 1 to 5. To evaluate the level of sedation, we used the scale of Ramsay from 1 to 6. To evaluate the grade of anxiety we used the Spilberger State-Trait Inventory sort form. Results: The blood pressure, heart rate and pulse oxymetry were constant in both groups from from the premedication up to the discharge. The level of analgesia, the grade of sedation and anxiety in both groups were satisfactory. The average of OTFC used was 210 μg and 434.78 μg in the group A and B respectively. Times between the premedication up to the discharge were: A 1.8 ± 0.7 h. y B 2.6 ± 1 1 h. 99.3% of the patients found OTFC excellent. Conclusions: This study demonstrates that the OTFC is an effective anxiolytic in patients who undergo diagnostic and therapeutic hysteroscopy.

Keywords : OTFC (oral transmucosal fentanyl citrate); hysteroscopy; anxiolytic; analgesic.

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