Abstract
ObjectiveTo compare pain measured with a new electronic device – the Continuous Pain Score Meter (CPSM) – and the Verbal Rating Scale (VRS) during gynaecological procedures in an outpatient setting, and to correlate these outcomes with baseline anxiety and patient (in)tolerance to the procedure. Study designThis prospective cohort study was undertaken in two centres: a university hospital and a large teaching hospital in The Netherlands. Patients undergoing an outpatient hysteroscopy, colposcopy or ovum pick-up procedure for in-vitro fertilization in one of the two participating hospitals with availability of the CPSM were included. Pain was measured by both the CPSM and the VRS. Patient tolerance to the procedure was reported. Various outcomes of the CPSM were compared with those of the VRS and related to baseline anxiety scores. ResultsNinety-one of 108 included patients (84 %) used the CPSM correctly during the procedure, and it was possible to analyse the CPSM scores for 87 women (81 %). The CPSM scores were all linearly related to the VRS. The peak pain score on the CPSM (CPSM-PPS) had the strongest correlation with the VRS score for all three procedures. Higher CPSM-PPS was related to patient (in)tolerance to the procedure (p = 0.03–0.002). Anxiety at baseline was not correlated with pain perception, except for VRS during colposcopy (r = 0.39, p = 0.016). ConclusionThe majority of patients were able to use the CPSM correctly, resulting in detailed information on pain perception for each individual pain stimulus during three outpatient gynaecological procedures. The CPSM-PPS had the strongest correlation with the VRS score and patient (in)tolerance to the procedure.
Highlights
Invasive surgery has evolved in all surgical disciplines
Higher Verbal Rating Scale (VRS) scores were registered in women who failed to use the Continuous Pain Score Meter (CPSM) correctly; 65 % of the 17 patients who did not use the CPSM correctly scored above the median score for the patients who used the CPSM correctly
It appears to be more difficult to execute this task while experiencing severe pain; by controlling the CPSM slider, patients may feel a greater degree of control, which could be even more relevant for anxious patients
Summary
More and more gynaecological procedures are performed in an outpatient setting given the health and economic benefits of these minimally invasive procedures [1,2,3]. Diagnostic and therapeutic hysteroscopies are performed increasingly in outpatient settings [4,5,6,7]. Pain perception can differ widely between patients and could be aggravated by anxiety [13,14,15], underlining the need for pain measurement and assessment of patient tolerability [16,17]. Obtaining detailed information on pain perception during different parts of a procedure enables adjustments that aim to reduce pain and improve perceived tolerance and the success rate of specific interventions
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