Lewis, Alexandra
(2024)
Acute Pain Management in Outpatient Gynecological Procedures: A Scoping Review.
Master Essay, University of Pittsburgh.
Abstract
Pain management for outpatient gynecological procedures is a nuanced and inconsistent experience in the United States. Currently, there are no set operating procedures for healthcare providers on best practices for acute pain management for the majority of common outpatient gynecological procedures. This is of public health significance as the negative experiences of excessive pain during procedures has the potential to increase short term complications, reduce follow up visit compliance of patients, and increase mistrust of the medical community by the general public. This scoping review examines current interventions, procedural methodologies, patient and provider attitudes and experiences, barriers to pain management, and risk factors that have been studied within the past ten years. One reviewer used OVID to find relevant research that was published surrounding United States based procedures including IUD insertion/removals, endometrial or cervical biopsies, uterine aspiration, colposcopy, loop electrosurgical excisional procedure (LEEP), hysteroscopy, endometrial ablation, and the coordinated pain, pain management, anxiety, and patient/provider experiences. A total of 656 potential articles were identified, 181 full text articles were reviewed, and 40 were included in this review. Findings of the review indicated that pain management likely needs to consist of a multimodal approach specific to each type of procedure, and that best practices have not been identified yet for most procedures. IUD insertions were the only exception, with a 20 mL buffered 1% lidocaine paracervical block showing a reduction in overall pain in nulliparous people. Anxiety was additionally shown to play a large part in the pain experiences of patients, and should be considered as a moderating factor that should be addressed as well. In summary, pain management for outpatient gynecological procedures requires more extensive research into multimodal approaches that factor in patient history and clinical facility capabilities.
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Details
| Item Type: |
Other Thesis, Dissertation, or Long Paper
(Master Essay)
|
| Status: |
Unpublished |
| Creators/Authors: |
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| Contributors: |
| Contribution | Contributors Name | Email | Pitt Username | ORCID  |
|---|
| Committee Chair | Hawk, Mary | mary.hawk@pitt.edu | mary.hawk | UNSPECIFIED | | Committee Member | Krekanova, Vera | verak@pitt.edu | verak | UNSPECIFIED |
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| Date: |
21 May 2024 |
| Date Type: |
Completion |
| Submission Date: |
19 April 2024 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
61 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Behavioral and Community Health Sciences |
| Degree: |
MPH - Master of Public Health |
| Thesis Type: |
Master Essay |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
pain, pain management, anxiety, gynecology, clinical procedures, best practices, scoping review |
| Date Deposited: |
21 May 2024 13:39 |
| Last Modified: |
21 May 2024 13:39 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/46209 |
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