A randomised controlled trial to evaluate the effect of self administereed analgesia on women's experience of outpatient treatment at colposcopy

Margaret Eleanor Cruickshank, G. B. Anthony, Ann Elizabeth Fitzmaurice, D. McConnell, Wendy Jane Graham, David Alan Alexander, Mike E. Tunstall, John A S Ross

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective To evaluate the effect of self-administered isoflurane and desflurane on women's experience of outpatient treatment at colposcopy.

Design A prospective double-blinded randomised controlled trial.

Setting A colposcopy clinic serving a regional population.

Population Three hundred and ninety-six women scheduled for treatment of cervical intraepithelial neoplasia (CIN) by large loop excision of the transformation zone (LLETZ).

Methods Self-administration of trial gas during a LLETZ procedure. One hundred and ninety-eight women were randomised to use isoflurane and desflurane and 198 to use placebo.

Main outcome measures Patient satisfaction, pain and anxiety.

Results The mean pain score for cervical surgery was significantly lower for women using isoflurane and desflurane (22.4) than the placebo arm (29.6) (P = 0.003). There was no significant difference between arms in anxiety levels before or after treatment. More women using isoflurane and desflurane (78%) reported 'total helpfulness' of the trial gas than those using placebo (67%) (P = 0.012). A subgroup analysis of trial participants classified as anxious by Hospital Anxiety and Depression Scale (HADS) score at recruitment showed that using isoflurane and desflurane significantly increased total treatment acceptability, helpfulness of the gas and willingness to undergo a similar procedure at six-month follow up.

Conclusion Satisfaction with outpatient treatment at colposcopy is generally high. The main effect of isoflurane and desflurane evaluated in this trial was to reduce pain. It appeared to be effective for women with clinically significant anxiety and could be offered as an alternative to general anaesthesia.

Original languageEnglish
Pages (from-to)1652-1658
Number of pages7
JournalBJOG-An International Journal of Obstetrics and Gynaecology
Volume112
Issue number12
DOIs
Publication statusPublished - 2005

Keywords

  • Adult
  • Ambulatory Care
  • Analgesia, Patient-Controlled
  • Anesthetics, Inhalation
  • Anxiety
  • Cervical Intraepithelial Neoplasia
  • Colposcopy
  • Double-Blind Method
  • Female
  • Humans
  • Isoflurane
  • Pain, Postoperative
  • Patient Satisfaction
  • Prospective Studies
  • Uterine Cervical Neoplasms

Cite this

A randomised controlled trial to evaluate the effect of self administereed analgesia on women's experience of outpatient treatment at colposcopy. / Cruickshank, Margaret Eleanor; Anthony, G. B.; Fitzmaurice, Ann Elizabeth; McConnell, D.; Graham, Wendy Jane; Alexander, David Alan; Tunstall, Mike E.; Ross, John A S.

In: BJOG-An International Journal of Obstetrics and Gynaecology, Vol. 112, No. 12, 2005, p. 1652-1658.

Research output: Contribution to journalArticle

Cruickshank, Margaret Eleanor ; Anthony, G. B. ; Fitzmaurice, Ann Elizabeth ; McConnell, D. ; Graham, Wendy Jane ; Alexander, David Alan ; Tunstall, Mike E. ; Ross, John A S. / A randomised controlled trial to evaluate the effect of self administereed analgesia on women's experience of outpatient treatment at colposcopy. In: BJOG-An International Journal of Obstetrics and Gynaecology. 2005 ; Vol. 112, No. 12. pp. 1652-1658.
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abstract = "Objective To evaluate the effect of self-administered isoflurane and desflurane on women's experience of outpatient treatment at colposcopy.Design A prospective double-blinded randomised controlled trial.Setting A colposcopy clinic serving a regional population.Population Three hundred and ninety-six women scheduled for treatment of cervical intraepithelial neoplasia (CIN) by large loop excision of the transformation zone (LLETZ).Methods Self-administration of trial gas during a LLETZ procedure. One hundred and ninety-eight women were randomised to use isoflurane and desflurane and 198 to use placebo.Main outcome measures Patient satisfaction, pain and anxiety.Results The mean pain score for cervical surgery was significantly lower for women using isoflurane and desflurane (22.4) than the placebo arm (29.6) (P = 0.003). There was no significant difference between arms in anxiety levels before or after treatment. More women using isoflurane and desflurane (78{\%}) reported 'total helpfulness' of the trial gas than those using placebo (67{\%}) (P = 0.012). A subgroup analysis of trial participants classified as anxious by Hospital Anxiety and Depression Scale (HADS) score at recruitment showed that using isoflurane and desflurane significantly increased total treatment acceptability, helpfulness of the gas and willingness to undergo a similar procedure at six-month follow up.Conclusion Satisfaction with outpatient treatment at colposcopy is generally high. The main effect of isoflurane and desflurane evaluated in this trial was to reduce pain. It appeared to be effective for women with clinically significant anxiety and could be offered as an alternative to general anaesthesia.",
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author = "Cruickshank, {Margaret Eleanor} and Anthony, {G. B.} and Fitzmaurice, {Ann Elizabeth} and D. McConnell and Graham, {Wendy Jane} and Alexander, {David Alan} and Tunstall, {Mike E.} and Ross, {John A S}",
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T1 - A randomised controlled trial to evaluate the effect of self administereed analgesia on women's experience of outpatient treatment at colposcopy

AU - Cruickshank, Margaret Eleanor

AU - Anthony, G. B.

AU - Fitzmaurice, Ann Elizabeth

AU - McConnell, D.

AU - Graham, Wendy Jane

AU - Alexander, David Alan

AU - Tunstall, Mike E.

AU - Ross, John A S

PY - 2005

Y1 - 2005

N2 - Objective To evaluate the effect of self-administered isoflurane and desflurane on women's experience of outpatient treatment at colposcopy.Design A prospective double-blinded randomised controlled trial.Setting A colposcopy clinic serving a regional population.Population Three hundred and ninety-six women scheduled for treatment of cervical intraepithelial neoplasia (CIN) by large loop excision of the transformation zone (LLETZ).Methods Self-administration of trial gas during a LLETZ procedure. One hundred and ninety-eight women were randomised to use isoflurane and desflurane and 198 to use placebo.Main outcome measures Patient satisfaction, pain and anxiety.Results The mean pain score for cervical surgery was significantly lower for women using isoflurane and desflurane (22.4) than the placebo arm (29.6) (P = 0.003). There was no significant difference between arms in anxiety levels before or after treatment. More women using isoflurane and desflurane (78%) reported 'total helpfulness' of the trial gas than those using placebo (67%) (P = 0.012). A subgroup analysis of trial participants classified as anxious by Hospital Anxiety and Depression Scale (HADS) score at recruitment showed that using isoflurane and desflurane significantly increased total treatment acceptability, helpfulness of the gas and willingness to undergo a similar procedure at six-month follow up.Conclusion Satisfaction with outpatient treatment at colposcopy is generally high. The main effect of isoflurane and desflurane evaluated in this trial was to reduce pain. It appeared to be effective for women with clinically significant anxiety and could be offered as an alternative to general anaesthesia.

AB - Objective To evaluate the effect of self-administered isoflurane and desflurane on women's experience of outpatient treatment at colposcopy.Design A prospective double-blinded randomised controlled trial.Setting A colposcopy clinic serving a regional population.Population Three hundred and ninety-six women scheduled for treatment of cervical intraepithelial neoplasia (CIN) by large loop excision of the transformation zone (LLETZ).Methods Self-administration of trial gas during a LLETZ procedure. One hundred and ninety-eight women were randomised to use isoflurane and desflurane and 198 to use placebo.Main outcome measures Patient satisfaction, pain and anxiety.Results The mean pain score for cervical surgery was significantly lower for women using isoflurane and desflurane (22.4) than the placebo arm (29.6) (P = 0.003). There was no significant difference between arms in anxiety levels before or after treatment. More women using isoflurane and desflurane (78%) reported 'total helpfulness' of the trial gas than those using placebo (67%) (P = 0.012). A subgroup analysis of trial participants classified as anxious by Hospital Anxiety and Depression Scale (HADS) score at recruitment showed that using isoflurane and desflurane significantly increased total treatment acceptability, helpfulness of the gas and willingness to undergo a similar procedure at six-month follow up.Conclusion Satisfaction with outpatient treatment at colposcopy is generally high. The main effect of isoflurane and desflurane evaluated in this trial was to reduce pain. It appeared to be effective for women with clinically significant anxiety and could be offered as an alternative to general anaesthesia.

KW - Adult

KW - Ambulatory Care

KW - Analgesia, Patient-Controlled

KW - Anesthetics, Inhalation

KW - Anxiety

KW - Cervical Intraepithelial Neoplasia

KW - Colposcopy

KW - Double-Blind Method

KW - Female

KW - Humans

KW - Isoflurane

KW - Pain, Postoperative

KW - Patient Satisfaction

KW - Prospective Studies

KW - Uterine Cervical Neoplasms

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DO - 10.1111/j.1471-0528.2005.00782.x

M3 - Article

VL - 112

SP - 1652

EP - 1658

JO - BJOG-An International Journal of Obstetrics and Gynaecology

JF - BJOG-An International Journal of Obstetrics and Gynaecology

SN - 1470-0328

IS - 12

ER -