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( Ladan Haghighi ),( Zahra Najmi ),( Samaneh Rokhgireh ),( Yousef Moradi ),( Candidate ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.4
Objective The aim of the present study was to compare the efficacy of vaginal isoniazid (isonicotinic acid hydrazide [INH]) and vaginal misoprostol in cervical ripening before hysteroscopic surgery. Methods This randomized controlled trial included patients scheduled for hysteroscopic surgery during April 2016 and June 2017. The inclusion criteria were as follows: postmenopausal women or those at premenopausal age who had not had a vaginal delivery and candidate for diagnostic or operative hysteroscopy with closed cervix before intervention. The INH group (intervention group) received 900 mg of vaginal isoniazid (three 300-mg pills) 6-8 hours before hysteroscopic surgery. The misoprostol group (control group) received 400 micrograms of vaginal misoprostol 6-8 hours before hysteroscopic surgery. Finally, the efficacy of the 2 agents was comparatively analyzed. Results Baseline characteristics were comparable between the groups. In 67 cases in the INH group (95%) and 45 in the misoprostol group (50%), hysteroscopic entry was successful without additional mechanical dilation, and this difference was statistically significant (P=0.001). The odds ratio (OR) obtained in this study was 0.57 for both INH and misoprostol groups (OR, 0.57; 95% confidence interval, 0.43-0.75). Further, 19 cases in the INH group vs. 45 cases in the misoprostol group did not respond to the intervention, indicating statistically significance (P=0.001). Conclusion Vaginal INH is more effective than misoprostol in cervical ripening before hysteroscopic surgery and can be a good alternative to misoprostol.
Kobra Tahermanesh,Abolfazl Mehdizadeh Kashi,Marziyeh Ajdary,Samaneh Rokhgireh,Masood Mohseni,Shahla Chaichian,Maryam Ahmadi 대한산부인과학회 2022 Obstetrics & Gynecology Science Vol.65 No.6
ObjectiveThe effect of ropivacaine on postoperative hysteroscopy has not yet been evaluated; this study investigated the effectof diluted ropivacaine in distending media during hysteroscopy on postoperative cramping pain. MethodsThis double-blind randomized clinical trial was conducted on 60 women who underwent hysteroscopy at a tertiaryhospital. Normal saline was used as the distending fluid in both groups. The intervention group received 10 mLof 2% ropivacaine in only one bottle of 1,000 mL normal saline as a distending fluid, while the control groupreceived 10 mL of normal saline in 1,000 mL normal saline during hysteroscopy. Patients’ pain scores wereevaluated before hysteroscopy and at 2, 6, 12, 24, and 48 hours after hysteroscopy. ResultsBased on the results, the pain measured by visual analog scale (VAS) score was significant at 6 and 12 hours after theintervention was significantly lower than that in the ropivacaine group (3.03±1.57 vs. 4±1.49, P=0.02 at 6 hours and1.28±1.36 vs. 2.4±1.43, P=0.003 at 12 hours). There were no significant differences in the VAS scores at 2, 24, and 48hours after the intervention between the two groups. ConclusionRopivacaine in the distending fluid during hysteroscopy is associated with a significant reduction in pain within a fewhours after hysteroscopy with no remarkable adverse effects.