• All gynaecology departments should provide a dedicated outpatient hysteroscopy service to aid care of women and people with abnormal uterine bleeding, reproductive problems, and insertion/retrieval of intrauterine devices. [Grade A]
• Written information should be provided to the woman prior to their appointment. This should include details about the procedure, the benefits and risks, advice regarding pre-operative analgesia, as well as alternative options for care and contact details for the hysteroscopy unit. [Good Practice Point]
• Women should be made aware of other settings and modes of anaesthesia for hysteroscopy (e.g. under general or regional anaesthesia or intravenous sedation). [GPP]
• The woman should be advised that if they find the procedure too painful or distressing at any point, they must alert the clinical team who will stop the procedure immediately. The clinical team should alert the hysteroscopist if the woman appears to be in too much pain or is experiencing a vasovagal episode and therefore unable to voice the concerns so that the procedure can be stopped. [GPP]
• Women should be advised to take standard doses of oral non-steroidal anti-inflammatory agents (NSAIDs) one hour before their scheduled appointment.
• Vaginoscopy should be the standard technique for outpatient hysteroscopy unless the use of a vaginal speculum is required (e.g. for administering local cervical anaesthesia or dilating the cervix). [Grade A]
• When performing operative hysteroscopy, the smallest diameter hysteroscope should be used, with consideration given to the use of hysteroscopes with expandable outer working channels because they are associated with less pain. [Grade B]
• Mechanical hysteroscopic tissue removal systems should be preferred over miniature bipolar electrodes to remove endometrial polyps. [Grade A]
• Local anaesthesia should not be routinely administered prior to outpatient hysteroscopy where a vaginoscopic approach is used. It should be considered where use of a vaginal speculum is planned e.g. for cervical dilatation if anticipated, due to either cervical stenosis and/or the utilisation of larger-diameter hysteroscopes (≥5mm outer diameter). [Grade A]
• Saline should be instilled at the lowest possible pressure to achieve a satisfactory view. [Grade A]
• Conscious sedation should not be routinely used in outpatient hysteroscopic procedures. [Grade B]

中文翻译：

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 门诊宫腔镜检查

• 
  所有妇科部门都应提供专门的门诊宫腔镜服务，以帮助护理女性和有异常子宫出血、生殖问题和宫内节育器插入/取出的人。[A 级]
• 
  应在预约前向女性提供书面信息。这应包括有关手术、益处和风险的详细信息、有关术前镇痛的建议，以及护理的替代选择和宫腔镜检查装置的联系方式。[良好做法要点]
• 
  应告知女性宫腔镜检查的其他麻醉环境和模式（例如，全身或区域麻醉或静脉镇静）。[GPP]
• 
  应告知女性，如果她们发现手术在任何时候太痛苦或令人痛苦，她们必须通知临床团队，临床团队将立即停止手术。如果女性看起来太痛苦或正在经历血管迷走神经发作，因此无法表达担忧，临床团队应提醒宫腔镜医师，以便停止手术。[GPP]
• 
  应建议女性在预约前一小时服用标准剂量的口服非甾体抗炎药 （NSAID）。
• 
  阴道镜检查应是门诊宫腔镜检查的标准技术，除非需要使用阴道窥器（例如，用于局部宫颈麻醉或扩张宫颈）。[A 级]
• 
  进行手术宫腔镜检查时，应使用最小直径的宫腔镜，并考虑使用具有可扩展外部工作通道的宫腔镜，因为它们的疼痛较小。[B 级]
• 
  在切除子宫内膜息肉时，应首选机械宫腔镜组织切除系统，而不是微型双极电极。[A 级]
• 
  在使用阴道镜方法的门诊宫腔镜检查之前，不应常规进行局部麻醉。在计划使用阴道窥器的情况下应考虑使用阴道窥器，例如由于宫颈狭窄和/或使用更大直径的宫腔镜（外径 ≥5 毫米），如果预期用于宫颈扩张。[A 级]
• 
  应以尽可能低的压力滴入盐水以获得令人满意的视野。[A 级]
• 
  清醒镇静不应常规用于门诊宫腔镜手术。[B 级]