"Pain Relief for Office Hysteroscopy: A Randomized Controlled Trial Comparing a Transcutaneous Electric Nerve Stimulation and Placebo

Abstract
Background: The efficacy of transcutaneous electrical nerve stimulation (TENS) as a non-invasive method for pain management during office-based hysteroscopy requires additional investigation.
Objective: To evaluate the analgesic effects of transcutaneous electrical nerve stimulation (TENS) in office hysteroscopy procedures and the level of patient satisfaction with this intervention.
Patients and Methods:
The study employed a double-blind randomized controlled trial design, which included a sample of 120 female participants who underwent office hysteroscopy. The participants were categorized into two groups: the TENS group (N = 60) received active transcutaneous electrical nerve stimulation (TENS) during office hysteroscopy using a health tronic alpha wave TENS instrument (Model MB - 1004) with four large pads, two channels, two leads, a pulse width of 200 µs, and a pulse frequency ranging from 40 to 100 Hz. The Placebo group (N = 60) received placebo TENS during office hysteroscopy.

Results: Following the hysteroscopy procedure at the office, both the TENS and placebo study groups exhibited comparable levels of pain, with no statistically significant differences observed in terms of the Visual Analogue Scale (VAS) assessment (p = 0.311) and the intensity of pain (p = 0.11). No statistically significant difference was seen in the satisfaction rating between the two groups when using the verbal Likert scale (p = 0.351). The study found a significant positive correlation between the VAS score and the age (r = 0.256, P <0.001) as well as the parity (r = 0.404, p <0.001). Conversely, a negative correlation was seen between the VAS score and the participants' height (r = -0.317, p <0.001) and Likert verbal scale (r = -0.278, p <0.001).
Conclusion: The TENS device does not provide a substantial alleviation of the pain linked to office hysteroscopy
Keywords: Hysteroscopy, TENS, Pain.