Use of sublingual buprenorphine for pain relief in office hysteroscopy

STUDY OBJECTIVE: To assess the efficacy of sublingual buprenorphine in the relief of pain associated with office hysteroscopy. DESIGN: Prospective, randomized study (Canadian Task Force classification I). SETTING: Tertiary medical center. PATIENTS: One hundred sixty-four women referred for office hysteroscopy from September 2003 through March 2004. INTERVENTION: Before hysteroscopy, 80 women received a tablet of buprenorphine (group A), and 84 women received a placebo (group B). Their pain sensations were evaluated on a 10-cm visual analog scale, and they were asked about the adverse reactions and level of satisfaction on the following day. MEASUREMENTS AND MAIN RESULTS: The pain score in group A was 3.3 ± 1.1, which was similar to 3.2 ± 1.3 in group B. The pain scores in subgroups of women also were similar within the same group and between the two groups. Thirty-one women (38.8%) in group A reported adverse reactions, including nausea, vomiting, and drowsiness, while none in group B reported any adverse reactions. CONCLUSION: Office hysteroscopy with a 3.1-mm flexible hysteroscope is a well-tolerated procedure. Sublingual buprenorphine is not helpful in relieving the pain associated with hysteroscopy but is associated with significant adverse reactions.