A Randomized, Single Blind, Placebo-Controlled Trial for the Pain Reduction During the Outpatient Hysteroscopy After Ketoprofen or Intravaginal Misoprostol

Issat, Tadeusz; Beta, J.; Nowicka, M.A.; Maciejewski, T.; Jakimiuk, Artur

doi:10.1016/j.jmig.2014.04.006

Cited by 50 publications

(33 citation statements)

References 41 publications

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“…ketoprofen versus intravaginal misoprostol for pain relief during outpatient hysteroscopy (18). They found that 400 µg vaginal misoprostol 4 hour before the procedure was beneficial in reducing pain but their ketoprofen group's VAS score was comparable with that of the placebo group (18). Our data are consistent with all these data; we found no beneficial effects with either indomethacin and diclofenac sodium in reducing pain during office hysteroscopy.…”

Section: Discussionsupporting

confidence: 89%

“…To our knowledge, five trials studied the use of NSAIDs (14)(15)(16)(17)(18) (15,16,18). Nagele et al performed a doubleblind, placebo-controlled trial with 95 patients and found that when 500 mg mefenamic acid was given one hour before hysteroscopy, it had no significant benefit in the discomfort experienced during the procedure but significantly reduced pain after hysteroscopy (15).…”

Section: Discussionmentioning

confidence: 99%

“…More recently, Issat et al performed a placebo-controlled study to assess the efficacy of I.V. ketoprofen versus intravaginal misoprostol for pain relief during outpatient hysteroscopy (18). They found that 400 µg vaginal misoprostol 4 hour before the procedure was beneficial in reducing pain but their ketoprofen group's VAS score was comparable with that of the placebo group (18).…”

Section: Discussionmentioning

confidence: 99%

“…Drugs are quickly absorbed and the analgesic effect begins more quickly than the oral route. Additionally, first pass metabolism is avoided in rectal administration (14)(15)(16)(17)(18)(19)(20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Surgical Education

Vaziri

2013

J Minim Invasive Surg Sci

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Surgical Education

Vaziri

2013

J Minim Invasive Surg Sci

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“…[1][2][3] Several modalities such as misoprostol, ketoprofen, lidocaine, laminaria, and so on for cervical priming and pain reduction before hysteroscopy have been adopted to reduce the complications related to cervical dilatation. [4][5][6] Among them, the prostaglandin analog misoprostol is the most frequently used agent for cervical preparation before hysteroscopy because of its low cost and previous testing in many randomized, controlled trials. [7][8][9][10] Phloroglucinol, a spasmolytic, is primarily used for gastrointestinal tract colic.…”

mentioning

confidence: 99%

A Prospective, Randomized Comparison of Intramuscular Phloroglucinol Versus Oral Misoprostol for Cervix Pretreatment Before Diagnostic Hysteroscopy

Zhang

2015

International Surgery

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The aim of this study was to compare the effectiveness and safety of intramuscular phloroglucinol and oral misoprostol for cervix pretreatment before diagnostic hysteroscopy. Several modalities for cervical priming and pain reduction have been adopted to reduce the complications related to cervical dilatation before hysteroscopy. Among them, the prostaglandin analog misoprostol is the most frequently used agent. Phloroglucinol, a spasmolytic, has also been showed to have an effect in inducing cervical dilatation but is rarely used before hysteroscopy. One hundred twenty outpatients undergoing anesthesia-free diagnostic hysteroscopy were randomly assigned to receive 80 mg intramuscular phloroglucinol and 400 mg oral misoprostol before diagnostic hysteroscopy. The main outcome measures were preoperative cervical width, visual analog scales (VAS) for pain, cervical passage time, and adverse reactions. Intramuscular phloroglucinol resulted in a significantly wider cervical width, lower VAS pain score, shorter cervical passage time, and a lower adverse effects rate compared with oral misoprostol. Intramuscular phloroglucinol is more effective and safer than oral misoprostol in inducing proper cervical priming and may be the optimal choice for cervical pretreatment before diagnostic hysteroscopy.

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Comparative efficacy of lidocaine–prilocaine cream and vaginal misoprostol in reducing pain during levonorgestrel intrauterine device insertion in women delivered only by cesarean delivery: A randomized controlled trial

Hashem

Mahmoud

Islam

et al. 2022

Intl J Gynecology & Obste

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ObjectiveTo compare efficacy of lidocaine–prilocaine (LP) cream versus misoprostol versus placebo before levonorgestrel‐releasing intrauterine device (LNG‐IUD) insertion.MethodsThis randomized controlled trial (RCT) was conducted in a tertiary referral hospital from April 30, 2020 to March 1, 2021 on 210 parous women willing to receive LNG‐IUD and delivered only by elective cesarean delivery (CD). Participants received 200 μg vaginal misoprostol or 5 ml of LP cream 5% or placebo 3 h before LNG‐IUS insertion. Primary outcome was pain during LNG‐IUD insertion, while secondary outcomes were pain 10 min post‐procedure, ease of insertion, patient satisfaction, insertion time, and drug side effects.ResultsPain during LNG‐IUS insertion was reduced in LP group and misoprostol group compared to placebo group (2.1 ± 1.0 vs 3.7 ± 1.6; p <0.001) and (2.3 ± 1.3 vs 3.7 ± 1.6; p <0.001), respectively. Ease of procedure and patient satisfaction were significantly higher in LP and misoprostol groups than placebo (P <0.001). Need for additional analgesia was significantly higher in placebo group than in the other two groups (P = 0.009). Adverse events were not significantly different between the three groups except vomiting and abdominal cramps, which were higher with misoprostol.ConclusionLP cream and 200 μg of vaginal misoprostol administration before LNG‐IUD insertion in women delivered only by elective CD effectively reduced pain during insertion and 10 min post‐procedure with easier insertions, high patient satisfaction, and tolerable side effects. Pain reduction with LP cream was clinically significant.

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A Randomized, Single Blind, Placebo-Controlled Trial for the Pain Reduction During the Outpatient Hysteroscopy After Ketoprofen or Intravaginal Misoprostol

Cited by 50 publications

References 41 publications

Laparoscopic Surgical Education

Laparoscopic Surgical Education

A Prospective, Randomized Comparison of Intramuscular Phloroglucinol Versus Oral Misoprostol for Cervix Pretreatment Before Diagnostic Hysteroscopy

Comparative efficacy of lidocaine–prilocaine cream and vaginal misoprostol in reducing pain during levonorgestrel intrauterine device insertion in women delivered only by cesarean delivery: A randomized controlled trial

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