Is Anesthesia Required For A Hysteroscopy?

Hysteroscopy refers to an investigative procedure that involves looking into the uterus or womb with a telescope-like device, called a hysteroscope. As the device is inserted through the vagina, it doesn’t cause any incision to the abdomen, cervix, or uterus.

The doctor may suggest this procedure to find the cause of the following problems:

• If you have heavy vaginal bleeding
• If you are undergoing irregular periods
• In case of excessive bleeding between periods
• In case of bleeding after sexual intercourse
• If you have bleeding after menopause
• In case of persistent discharge
• In case of abnormalities of the uterus.

In addition, the doctor may recommend hysteroscopy when the uterus appears to have an abnormal shape. Minor procedures may be done at the same time to treat the condition, which includes:

• To remove, insert, or change an intra-uterine contraceptive device
• Removal of polyps or fibroids.

Types of Hysteroscopy

Diagnostic Hysteroscopy

Diagnostic hysteroscopy can either evaluate or diagnose various conditions. Additionally, it may be used to confirm the results of other tests, such as hysterosalpingography. This kind of hysteroscopy is suggested in the following cases:

• Infertility
• Abnormal uterine bleeding
• Repeated miscarriages
• Adhesions
• Fibroid tumors
• Polyps

Operative Hysteroscopy

As the name suggests, an operative hysteroscopy may be used to both diagnose and treat various conditions, including uterine adhesions, fibroids, septa, and more. Depending on the location, these conditions may sometimes be removed during the procedures. In conjunction with hysteroscopy, other instruments or techniques may be used, such as dilation and curettage, resectoscope, and laparoscopy. In some cases, a hysteroscopy may also be used with laparoscopy to diagnose and treat conditions related to infertility.

Is Anesthesia Required for a Hysteroscopy?

Before the procedure, the doctor may give you medication to help relax. It includes anesthesia in the following forms:

• Local Anesthesia: An injection will be administered around the cervix to numb it. With this type of anesthesia, you will remain awake and may also feel some cramping.
• Regional Anesthesia: A drug will be injected through a needle or tube in your lower back. It will block the nerves that receive sensation from the pelvic region. You will be awake through the procedure, but feel no discomfort.
• General Anesthesia: General anesthesia will make you unconscious during the procedure. The doctor will put a mask over your mouth and nose to allow you to breathe a mixture of gases. Once the effects of anesthesia show up, a tube will be inserted down your throat to help you breathe because this type of sedation interferes with natural breathing.

Depending on the reason for your hysteroscopy, the healthcare provider will determine suitable anesthesia.

Is Anesthesia Necessary during Hysteroscopy?

The decision whether anesthesia is required or not depends on the kind of hysteroscopy you are opting for. If ideal anesthesia is given, it will provide comfort and create an optimal operative environment for the procedure. The options in case of hysteroscopic anesthesia include the following:

• Local anesthesia infiltration with or without sedation, paracervical block with or without sedation
• Regional anesthesia, including spinal, epidural, or combined spinal-epidural anesthesia
• General anesthesia

In case of diagnostic hysteroscopy, the healthcare professional may use no anesthesia at all or a paracervical block, depending on the individual case. During the procedure, anesthesiologists are less involved. Depending on the indications for operative hysteroscopy, anesthesia may be administered generally or regionally. Regional anesthesia allows for early detection of fluid overload and other benefits over its general counterpart.

Some of the important considerations through preoperative assessment include the degree of uterine bleeding, symptoms of anemia, and associated coronary artery or cerebrovascular disease.

What are the Complications of Anesthesia during Hysteroscopy?

The healthcare professional must administer the right amount of anesthesia to the patient. If anesthesia is not administered at the right level, it may lead to possible complications, such as fluid overload, uterine perforation, infection, endometrial cancer, haemorrhage, recurrent bleeding, and the need for reoperation.  

Recovering from the Effects of Anesthesia?

After the procedure, you will be under the effects of anesthesia for some time. The care team will shift you to the recovery room, where you will be monitored by them until you are transferred back to the ward. The team will monitor your vitals from time to time and take routine observations. The doctor will consult with you and discuss the findings of the procedure.

As hysteroscopy is not an invasive procedure, you will be discharged from the hospital on the same day as soon as the effects of anesthesia wear off. The doctor will give you important instructions for looking after yourself during the post-operative period.

Takeaway

Whether or not anesthesia should be delivered during hysteroscopy is a matter of debate among doctors. That said, hysteroscopy is becoming increasingly common, and patients are requesting that the doctors give them anesthesia to relieve any kind of pain or anxiety before the procedure. And while administering anesthesia rarely causes any side effects, the care team must be aware and be ready to address potential hazards.