From the Guidelines
Pain management for ovarian cysts typically involves the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, 400-800mg every 6-8 hours, or acetaminophen, 650-1000mg every 4-6 hours, for a duration of 3-5 days 1.
Options for Pain Management
- NSAIDs: ibuprofen, 400-800mg every 6-8 hours, or
- Acetaminophen: 650-1000mg every 4-6 hours In cases of severe pain, oral opioids such as oxycodone, 5-10mg every 4-6 hours, or tramadol, 50-100mg every 4-6 hours, may be prescribed for a limited duration of 3-5 days 1.
Additional Therapies
- Hormonal therapies: combined oral contraceptives, with a typical regimen consisting of 20-35mcg of ethinyl estradiol and 0.1-0.3mg of levonorgestrel, taken daily for 21 days, followed by a 7-day hormone-free interval
- Coanalgesics: anticonvulsants, antidepressants, corticosteroids, and local anesthetics, which can be used to help manage bone pain, neuropathic pain, and visceral pain, and to reduce systemic opioid requirement 1 It is essential to consider the individual patient's needs and medical history when selecting a pain management strategy, and to monitor their response to treatment and adjust the plan as needed.
From the Research
Pain Management Options for Ovarian Cysts
The following options are available for pain management in patients with ovarian cysts:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) available via multiple routes, which can be effective for pain management 2, 3, 4, 5
- Acetaminophen, which can be used orally or intravenously, and may be associated with a faster onset of action when used intravenously 6
- Anticonvulsants, which can be especially effective for neuropathic pain associated with trauma or other conditions 6, 4
- Muscle relaxants and alpha-2 adrenergic agonists, which can be used as adjuvants for pain management 6
- Ketamine and regional techniques, which can play an important role in multimodal therapy but require medical and nursing support 6
- Nonpharmacologic treatments, such as cryotherapy, distraction techniques, breathing and relaxation, and acupuncture, which can supplement pharmacologic analgesics and be safe and easy to implement 6, 5
- Osteopathic manipulative treatment (OMT), which is a conservative, non-pharmacological treatment that can be used to help treat chronic pain associated with various conditions, including osteoarthritis 5
- Topical NSAIDs, such as diclofenac gel, which can provide an alternative to oral NSAIDs and minimize negative side effects 5
Considerations for Pain Management
When selecting a pain management option, it is essential to consider the individual patient's needs and medical history, as well as the potential risks and benefits of each treatment. For example:
- NSAIDs can be effective for pain management but may have negative side effects, such as cardiovascular risks, when used chronically 2, 5
- Opioids can be effective for pain management but may have risks of addiction and other adverse events, and their use should be carefully monitored 6, 3, 4
- Nonpharmacologic treatments can be safe and effective but may not be suitable for all patients, and their use should be individualized 6, 5