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AzTrials

HysteroscopyNCT06092541

Pericervical Analgesia Versus Analesia With Nitrous Oxide (N2O) in Outpatien Operative Hysteroscopy With Miniresector

A study testing Intervention Group: pericervical anesthesia and Nitroux Oxide anesthesia in people with Hysteroscopy, run by Ospedale degli Infermi di Biella at 1 site in Italy.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This research will have the aim of evaluating and comparing the effectiveness of two methods (analgesia with nitrous oxide and pericervical analgesia, excluding the use of paracervical block due to the increased risk of complications reported in the literature in the control of pain caused during Outpatient Operative… Read more about this study

Who is it for?
Ages 25 to 50 years, women onlyHealthy volunteers can take part
Conditions the study is for
Hysteroscopy
What is being tested?
Intervention Group: pericervical anesthesia and Nitroux Oxide anesthesia
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteItaly
Study dates
2 Oct 2023to 2 May 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 25 to 50 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • nulliparous or primiparous women (a previous Spontaneous Vaginal Birth -PS- or a previous Cesarean Section -TC- the latter comparable to nulliparous women as no previous cervical dilation -)
  • age between 25 and 50 years

Who cannot join

  • age < 25 or > 50 years
  • multiparity
  • positive history of previous operations on the cervical canal (e.g. conization)

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • Ospedale degli Infermi

    Biella

Other trials in Italy

About this study

Official title: Comparison of Efficacy Between Nitrous Oxide (n2o) Analgesia and Pericervical Analgesia in Outpatient Operative Hysteroscopy With Miniresector: a Randomized Clinical Pilot Study

This research will have the aim of evaluating and comparing the effectiveness of two methods (analgesia with nitrous oxide and pericervical analgesia, excluding the use of paracervical block due to the increased risk of complications reported in the literature in the control of pain caused during Outpatient Operative Hysteroscopy maneuvers with Miniresector.

Read the detailed description

Pain is the primary cause of hysteroscopy failure. It can be attributed to multiple causes, such as manipulation of the cervical canal , uterine distention due to the liquid distension media used during the procedure , operating procedures on the endometrium (as a possible cause of uterine contraction) , until the release of prostaglandins following manipulation of the cervix and uterine distension.

There are few studies in the literature that have compared the various methods of pain control during the hysteroscopic examination. Among these, Ahmad et al., for example, compared the use of the paracervical block and inhalation anesthesia during hysteroscopy: although both proved to be effective in controlling pain, the paracervical block was associated with a greater number of complications. More recently, Solano et al. they defined how the administration of nitrous oxide was equally effective (but with many more advantages) to the paracervical block with 1% lidocaine in controlling pain during hysteroscopy performed using the Bettocchi hysteroscope.

However, for the purposes of this research it is important to take two aspects into consideration:

  • all the studies in the literature that compared the various pain control methods during hysteroscopy were conducted using the Bettocchi Hysteroscope and not the Miniresector;
  • more in detail, there are no studies comparing the use of nitrous oxide and pericervical analgesia during outpatient operative hysteroscopy with miniresector.

Objective This clinical trial will have the aim of evaluating and comparing the effectiveness of two methods (analgesia with nitrous oxide and pericervical analgesia, excluding the use of paracervical block due to the increased risk of complications reported in the literature1) in the control of pain caused during Outpatient Operative Hysteroscopy maneuvers with Miniresector.

Conditions
Hysteroscopy
Being tested
Intervention Group: pericervical anesthesia, Nitroux Oxide anesthesia
Keywords
hysteroscopy, pain control, pericervical anesthesia, nitrous oxide
Medical subject headings
Agnosia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Intervention Group: pericervical anesthesiaDrug

    Also called Pericervical Anesthesia

    Patients assigned to the Intervention Group will receive Pericervical anesthesia before performing Hysteroscopy.

    Specifically, for the administration of pericervical analgesia, Mepivacaine/Lidocaine 1.5% 10/15 ml (max dose 7 mg/kg) will be used and pericervical infiltration will be performed at 0.5 cm depth at 3 and 9 hours.

  • Nitroux Oxide anesthesiaOther

    Also called N2O2 Anesthesia

    Patients assigned to the Control Group will receive Nitrous Oxide anesthesia before hysteroscopy

Study groups in NCT06092541
Study groupRoleWhat they receive
Intervention group: pericervical anesthesiaExperimentalIntervention group: pericervical anesthesia
Receives: Drug: Intervention Group: pericervical anesthesia
Control group: nitrous oxide anesthesiaActive comparatorControl group: nitrous oxide anesthesia
Receives: Other: Nitroux Oxide anesthesia

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Rate of pain, measured through the Visual Analog Scale 1 (no pain) to 10 (worse pain) using Pericervical Analgesia versus Analgesia with Nitrous Oxide in outpatient hysteroscopic surgery with Miniresector

    Change From Baseline in Pain Scores on the Visual Analog Scale -VAS- using Pericervical Analgesia versus Analgesia with Nitrous Oxide in outpatient hysteroscopic surgery with Miniresector

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Oct 2023
  2. Study start2 Oct 2023
  3. Primary completion2 May 2024
  4. Study completion2 May 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Single-blind, randomized clinical pilot study with masked third-party assessment. Patients will be assigned to the two groups (pericervical analgesia / nitrous oxide) through the sealed envelope method.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06092541
Sponsor's protocol ID
CE 130/2023
Status last verified
May 2024
First submitted
4 Oct 2023
Last updated
10 May 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: All collected IPD

Publications

  • Dealberti D, Riboni F, Prigione S, Pisani C, Rovetta E, Montella F, Garuti G. New mini-resectoscope: analysis of preliminary quality results in outpatient hysteroscopic polypectomy. Arch Gynecol Obstet. 2013 Aug;288(2):349-53. doi: 10.1007/s00404-013-2754-7. Epub 2013 Feb 16.

    PubMed 23417150
  • Ahmad G, Saluja S, O'Flynn H, Sorrentino A, Leach D, Watson A. Pain relief for outpatient hysteroscopy. Cochrane Database Syst Rev. 2017 Oct 5;(10)(10):CD007710. doi: 10.1002/14651858.CD007710.pub3.

    PubMed 35611933
  • Meyer L, Moore J, McMillan L. Outpatient Hysteroscopy in the Management of Abnormal Vaginal Bleeding. J Am Assoc Gynecol Laparosc. 1996 Aug;3(4, Supplement):S30-1. doi: 10.1016/s1074-3804(96)80239-8.

    PubMed 9074183
  • Zupi E, Luciano AA, Marconi D, Valli E, Patrizi G, Romanini C. The use of topical anesthesia in diagnostic hysteroscopy and endometrial biopsy. J Am Assoc Gynecol Laparosc. 1994 May;1(3):249-52. doi: 10.1016/s1074-3804(05)81018-7.

    PubMed 9050495
  • Solano Calvo JA, Del Valle Rubido C, Rodriguez-Miguel A, de Abajo FJ, Delgado Espeja JJ, Gonzalez Hinojosa J, Fernandez Munoz L, Zapico Goni A. Nitrous oxide versus lidocaine versus no analgesic for in-office hysteroscopy: a randomised clinical trial. BJOG. 2021 Jul;128(8):1364-1372. doi: 10.1111/1471-0528.16657. Epub 2021 Mar 9.

    PubMed 33528862
  • Del Valle Rubido C, Solano Calvo JA, Rodriguez Miguel A, Delgado Espeja JJ, Gonzalez Hinojosa J, Zapico Goni A. Inhalation analgesia with nitrous oxide versus other analgesic techniques in hysteroscopic polypectomy: a pilot study. J Minim Invasive Gynecol. 2015 May-Jun;22(4):595-600. doi: 10.1016/j.jmig.2015.01.005. Epub 2015 Jan 14.

    PubMed 25596171
  • De Silva PM, Carnegy A, Graham C, Smith PP, Clark TJ. Conscious sedation for office hysteroscopy: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2021 Nov;266:89-98. doi: 10.1016/j.ejogrb.2021.09.001. Epub 2021 Sep 3.

    PubMed 34600190
  • Vitale SG, Alonso Pacheco L, Haimovich S, Riemma G, De Angelis MC, Carugno J, Lasmar RB, Di Spiezio Sardo A. Pain management for in-office hysteroscopy. A practical decalogue for the operator. J Gynecol Obstet Hum Reprod. 2021 Jan;50(1):101976. doi: 10.1016/j.jogoh.2020.101976. Epub 2020 Nov 6.

    PubMed 33166706
  • De Silva PM, Mahmud A, Smith PP, Clark TJ. Analgesia for Office Hysteroscopy: A Systematic Review and Meta-analysis. J Minim Invasive Gynecol. 2020 Jul-Aug;27(5):1034-1047. doi: 10.1016/j.jmig.2020.01.008. Epub 2020 Jan 23.

    PubMed 31982584
  • Schneider EN, Riley R, Espey E, Mishra SI, Singh RH. Nitrous oxide for pain management during in-office hysteroscopic sterilization: a randomized controlled trial. Contraception. 2017 Mar;95(3):239-244. doi: 10.1016/j.contraception.2016.09.006. Epub 2016 Sep 9.

    PubMed 27621048
  • Munro MG, Brooks PG. Use of local anesthesia for office diagnostic and operative hysteroscopy. J Minim Invasive Gynecol. 2010 Nov-Dec;17(6):709-18. doi: 10.1016/j.jmig.2010.07.009.

    PubMed 20955982
  • Keyhan S, Munro MG. Office diagnostic and operative hysteroscopy using local anesthesia only: an analysis of patient reported pain and other procedural outcomes. J Minim Invasive Gynecol. 2014 Sep-Oct;21(5):791-8. doi: 10.1016/j.jmig.2014.03.006. Epub 2014 Mar 25.

    PubMed 24681061
  • De Iaco P, Marabini A, Stefanetti M, Del Vecchio C, Bovicelli L. Acceptability and pain of outpatient hysteroscopy. J Am Assoc Gynecol Laparosc. 2000 Feb;7(1):71-5. doi: 10.1016/s1074-3804(00)80012-2.

    PubMed 10648742
  • The Use of Hysteroscopy for the Diagnosis and Treatment of Intrauterine Pathology: ACOG Committee Opinion, Number 800. Obstet Gynecol. 2020 Mar;135(3):e138-e148. doi: 10.1097/AOG.0000000000003712.

    PubMed 32080054
  • Ahlbom A. Modern Epidemiology, 4th edition. TL Lash, TJ VanderWeele, S Haneuse, KJ Rothman. Wolters Kluwer, 2021. Eur J Epidemiol. 2021 Aug;36(8):767-768. doi: 10.1007/s10654-021-00778-w. Epub 2021 Jul 3. No abstract available.

    PubMed 34216355

Questions about this trial

What is this clinical trial studying?

A study testing Intervention Group: pericervical anesthesia and Nitroux Oxide anesthesia in people with Hysteroscopy, run by Ospedale degli Infermi di Biella at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 May 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rate of pain, measured through the Visual Analog Scale 1 (no pain) to 10 (worse pain) using Pericervical Analgesia versus Analgesia with Nitrous Oxide in outpatient hysteroscopic surgery with Miniresector (time frame: 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06092541, which also lists 15 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 May 2024.

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