Thermachoice endometrial ablation in the outpatient setting, without local anesthesia or intravenous sedation: a prospective cohort study.

Objective: To determine whether Thermachoice endometrial ablation (EA) is a safe and acceptable procedure when performed in the outpatient (OP) setting without local anesthesia or IV sedation.

Design: Prospective cohort (double group) study.

Setting: Hysteroscopy clinic of large UK hospital.

Patient(s): Twenty-seven women with menorrhagia.

Intervention(s): The first cohort of women underwent Thermachoice EA without elective analgesia. The second cohort underwent Thermachoice after taking ibuprofen.

Main Outcome Measure(s): To map pain scores and the requirement of "rescue analgesia." To assess speed of recovery and time away from home.

Result(s): Thermachoice EA was successfully performed in the OP setting on 89% (n = 24) of women. Four women in the first cohort required rescue analgesia compared to none in the second. During the procedure there was little difference between the groups visual analogue style pain scores-with the overall score being 3.6 (range = 0-10). Postoperatively there was a lower mean pain score in the second cohort, with fewer women experiencing nausea and vomiting. Mean time away from home was 2.6 hours and mean time to make a full recovery was 3.3 days. Women required analgesia for 2.6 days, on average, and returned to their normal activities at this time.

Conclusion(s): Thermachoice EA without local analgesia or IV sedation can be safely and successfully performed in the OP setting and if ibuprofen is taken preoperatively few women require "rescue analgesia."