Opioid Analgesia for Hysterosalpingography: Controlled Double-Blind Prospective Trial with Remifentanil and Placebo

Cengiz, Mustafa; Kafalı, Hasan; Artuç, Hülya; Baysal, Zeynep

doi:10.1159/000093427

Cited by 16 publications

(9 citation statements)

References 22 publications

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“…Fenoprofen, naproxen (both non-steroidal anti-inflammatory drugs) and tramadol were found to alleviate pain during the HSG procedure, however paracetamol was found to be ineffective (Owens et al, 1985;Peters et al, 1996;Elson and Ridley, 2000). Opiod analgesia with intravenous remifentanil was also found to be superior to placebo for HSG (Cengiz et al, 2006); however, the need for special care following IV narcotics and resultant costs make this intervention unfeasible.…”

Section: Introductionmentioning

confidence: 99%

Lidocaine–Prilocaine (EMLA) cream as analgesia for hysterosalpingography: a prospective, randomized, controlled, double blinded study

Liberty¹,

Gal²,

Halevy-Shalem³

et al. 2007

Human Reproduction

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BACKGROUND: The aim of our study is to evaluate the efficacy of applying lidocaine 25 mg-prilocaine-25 mg/G cream (EMLA 5%) on the uterine cervix for pain relief when performing hysterosalpingography (HSG). METHODS: Eighty-two patients undergoing HSG as part of infertility evaluation were randomized into groups receiving EMLA (42) or placebo cream (40) in a double-blinded prospective study from which four women were later excluded. The cream was applied to the uterine cervix by means of a cervical cup 30 min before the HSG. Pain perception related to the HSG procedure was scored by visual analogue scale (VAS) at five predefined steps: after speculum application, after cervical instrumentation of the tenaculum and cannula, at the end of uterine filling, at completion of tubal spillage, and immediately following instrument removal. In addition, the patients were asked to retrospectively rate the pain during the entire procedure in a telephone interview the following day. RESULTS: Cervical instrumentation was found to be the most painful step of HSG (P < 0.001). When comparing the VAS pain scores, cervical instrumentation in the EMLA-treated patients was associated with significantly less pain than the control group: 3.3+ + + + + 2.9 versus 4.9 + + + + + 2.7, respectively (P 5 0.02). CONCLUSION: Topical application of EMLA 5% cream on the uterine cervix before performing HSG significantly reduced the pain during this procedure.

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Section: Introductionmentioning

confidence: 99%

Lidocaine–Prilocaine (EMLA) cream as analgesia for hysterosalpingography: a prospective, randomized, controlled, double blinded study

Liberty¹,

Gal²,

Halevy-Shalem³

et al. 2007

Human Reproduction

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“…It is well known that the intravenous administration of opioids is valid for pain relief. In a previous study, Cengiz et al [29] explored the efficacy of the analgesic action of remifentanil compared with placebo during HSG procedure. VAS scores were recorded to assess pain during HSG in two groups.…”

Section: Discussionmentioning

confidence: 99%

Immersive virtual reality as analgesia for women during hysterosalpingography: study protocol for a randomized controlled trial

Wang

Gao

Wang

et al. 2020

Trials

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Background: Hysterosalpingography (HSG) is an accepted radiologic diagnostic modality for initial infertility workup, and is generally considered uncomfortable and painful. However, the management of pain related to HSG remains inefficient. As an emerging nonpharmacologic and noninvasive pain control strategy, virtual reality (VR) distraction has been successfully used in areas such as burns, blunt force trauma, hospital-based needle procedures, dental/periodontal procedures, and urological endoscopy patients. This study aims to evaluate the analgesic effect of VR during HSG.Methods/design: A single-center, parallel-group, randomized controlled trial will be carried out in the Radiology Department of Yinchuan Women and Children Healthcare Hospital, Yinchuan. A total of 200 participants who are scheduled for HSG will be enrolled in this study. The participants will be randomized (1:1) into two groups: a VR group and a blank control group. The VR group will receive routine care plus immersive VR intervention and the blank control group will receive routine care. Outcomes will be monitored at baseline, immediately after HSG and 15 min after HSG for each group. The primary outcome is the worst pain score during HSG by a visual analog scale (VAS). The secondary outcomes include: affective pain, cognitive pain, and anxiety during the HSG procedure; worst pain within 15 min after HSG; patient satisfaction and acceptance with pain management; physiological parameters; adverse effects; HSG results; and immersion perception score of the VR system (for the VR condition only).Discussion: This study will focus on exploring a simply operated, noninvasive and low-cost analgesia during the HSG procedure. The results of this trial will provide data on the feasibility and safety of VR distraction therapy during HSG.

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“…Peters et al 6 found the analgesic potency of tramadol and naproxen to be comparable, with a slightly higher incidence of adverse effects with tramadol use. Cengiz et al 9 found that the intravenous opioid analgesic remifentanil was superior to placebo for pain relief in HSG.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Flurbiprofen as Prophylactic Analgesic before Hysterosalpingography

2010

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Hysterosalpingography (HSG) is associated with pain during the four-step procedure. This prospective, double-blind, randomized, placebo-controlled study was conducted to investigate the effect of the analgesic flurbiprofen, administered prior to HSG, in 60 women. Thirty women were randomized to receive 100 mg of flurbiprofen, orally, 1 h prior to HSG and a further 30 women were randomized to receive placebo. Injection of contrast medium was more painful than the other steps in the HSG procedure in both groups; however, there was no significant between-group difference in terms of pain experienced in the individual steps of HSG. Pain scores at 5 and 30 min after the procedure were compared between the two groups. There was a significant decrease in the visual analogue scale pain score in the flurbiprofen-treated group compared with the placebo-treated group at both time points. Thus, the authors recommend flurbiprofen as a prophylactic analgesic to be administered before HSG procedures.

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Opioid Analgesia for Hysterosalpingography: Controlled Double-Blind Prospective Trial with Remifentanil and Placebo

Cited by 16 publications

References 22 publications

Lidocaine–Prilocaine (EMLA) cream as analgesia for hysterosalpingography: a prospective, randomized, controlled, double blinded study

Lidocaine–Prilocaine (EMLA) cream as analgesia for hysterosalpingography: a prospective, randomized, controlled, double blinded study

Immersive virtual reality as analgesia for women during hysterosalpingography: study protocol for a randomized controlled trial

The Effect of Flurbiprofen as Prophylactic Analgesic before Hysterosalpingography

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