Acupuncture Analgosedation in Minor Gynaecologic Operative-Diagnostic Procedures

Abstract

The aim of this study was to evaluate the effect of acupuncture analgosedation (AAS) in minor gynecologic operative-diagnostic procedures. Material and Methods: The prospective study included 43 women with minor gynecologic operative procedures. All women were treated using manual acupuncture (AP) points with analgetic and sedative effects. Out of a total of 43 women, 9 had cervical polyps, requiring polyp ablation, cervical channel excochleation (ECC), and dilatation, and curettage (D&C), and 2 patients required a paracervical anaesthesia (PCA) during dilatation of the cervical channel. ECC and D&C were done in 6 women with ultrasonographically suspicious endometrial neoplasias, in 10 women with perimenopausal metrorrhagia, and in 5 women with postmenopausal metrorrhagia. PCA was necessary in 1 woman with endometrial neoplasia, in 2 with perimenopausal metrorrhagia, and in 1 with postmenopausal metrorrhagia. In 2 cases the diagnosis was missed abortion and in 6 cases incomplete spontaneous miscarriage, requiring dilatation, evacuation, and curettage (D&E&C). In the group with missed abortion PCA was necessary in 2 and intravenous analgosedation (ivAS) in 1 woman. In a young nulliparous woman with incomplete spontaneous abortion, in addition to AAS, PCA and ivAS were required due to severe pain and psycho-emotional instability. Loop excision of the transformation zone is a very painful procedure, so 1 woman needed PCA and 1 woman ivAS. Sonohysterosalpingography was done twice for primary sterility and once for secondary sterility, for which MS was sufficient during the operation. In a total of 43 patients treated with AAS 10 PCA and 3 ivAS were additionally required. Results: A good analgosedative effect of AP during the operative-diagnostics procedures was achieved in 76.8% of cases. Conclusion: AAS requires the full commitment of the obstetrician or anaesthesiologist during the AP procedure, as well as a good pre-analgosedation interview, since the patient's motivation and psycho-emotional state during the choice of AP points should be taken into consideration.