The effect of hyoscine-N-butylbromide on pain perception during and after hysterosalpingography in infertile women: a systematic review and meta-analysis of randomised controlled trials

Aboshama, Rehab Abdelhamid; Shareef, Mohammad Abrar; AlAmodi, Abdulhadi A.; Kurdi, Wesam; Al-Tuhaifi, Mohammed M.; Bintalib, Marwah Ghazi; Sileem, Sileem Ahmed; Abdelazem, Osama; Abdelhakim, Ahmed Mohamed; Sobh, Ahmed M A; Elbaradie, Sahar M Y

doi:10.1080/14647273.2020.1842915

Cited by 4 publications

(7 citation statements)

References 28 publications

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“…In the present study, pain scores at contrast instillation, 30 minutes and 24 hours post-HSG were significantly lower in the women who received HnBB than in the placebo group. This finding is in accordance with a systematic review and meta-analysis by Aboshama et al [11] However, their study was limited by the few RCTs reviewed, and therefore, it recommended further RCTs to evaluate the benefit of HnBB for pain relief during HSG. [11] The finding in the present study is, however, in contrast with those of other authors, who reported no clinically significant difference in pain scores between women who received HnBB and those who did not.…”

Section: Discussionsupporting

confidence: 87%

“…This finding is in accordance with a systematic review and meta-analysis by Aboshama et al [11] However, their study was limited by the few RCTs reviewed, and therefore, it recommended further RCTs to evaluate the benefit of HnBB for pain relief during HSG. [11] The finding in the present study is, however, in contrast with those of other authors, who reported no clinically significant difference in pain scores between women who received HnBB and those who did not. [9,10,20,27] This study revealed that pain perception was highest during the instillation of contrast media.…”

Section: Discussionsupporting

confidence: 87%

“…[9] In contrast, Abbas et al concluded that HnBB had no benefit for pain reduction during and after HSG. [10] A systematic review and metaanalysis by Aboshama et al [11] corroborated the finding of Jitchanwichai and Soonthornpun and recommended further RCTs to evaluate the benefit of HnBB for pain relief during HSG owing to the small number and size of studies included in their review.…”

Section: Introductionmentioning

confidence: 92%

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Effect of Intramuscular Hyoscine-N-Butyl Bromide on Tubal Spasm and Pain Perception in Women with Infertility Undergoing Hysterosalpingography: A Randomised Controlled Trial

Oriji¹,

Kiridi²,

Kiridi³

et al. 2022

Ann Health Res

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Background: A tubal patency test is essential in evaluating women with infertility. Hysterosalpingography (HSG) is the investigation of choice for assessing tubal patency. Objective: To evaluate the effect of intramuscular hyoscine-N-butyl bromide on tubal spasms and pain perception during hysterosalpingography. Methods: This randomized, controlled trial was conducted at the Radiology Departments and Infertility Clinics of four health institutions in Bayelsa State, Nigeria, between January 2021 and April 2022. Five hundred and twenty infertile women undergoing hysterosalpingography were randomized into two groups. Women in group I (control) received a placebo, while women in Group II (experimental) received 20 mg of intramuscular hyoscine-N-butyl bromide. Pain scores at different steps of the procedure were recorded. Results: The overall mean pain scores progressively decreased from contrast instillation (4.97 ± 2.08) through 30-minutes post-procedure (3.54 ± 1.54) to 24 hours post-procedure (1.96 ± 1.78). Pain scores at contrast instillation, 30 minutes and 24 hours after HSG were significantly lower in the hyoscine group compared to the placebo group (p = 0.001 each). There were significantly fewer women with tubal blockage in the hyoscine group compared to the placebo group [78 (30.0%) vs 131 (50.4%); p = 0.001]. Conclusion: Intramuscular hyoscine-N-butyl bromide before hysterosalpingography significantly reduces pain and tubal spasm during the procedure.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 92%

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Effect of Intramuscular Hyoscine-N-Butyl Bromide on Tubal Spasm and Pain Perception in Women with Infertility Undergoing Hysterosalpingography: A Randomised Controlled Trial

Oriji¹,

Kiridi²,

Kiridi³

et al. 2022

Ann Health Res

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“…16 Jitchanwichai and Soonthornpun and Aboshama et al however corroborated our study findings in their RCT and systematic review and meta-analysis, respectively. 15,17 HBB has antispasmodic and peripheral anticholinergic effects on gastrointestinal, biliary and genitourinary system smooth muscle. 24 HBB reduces HSG-associated pain by relieving uterine spasm and blocking transmission of pain impulses in parasympathetic ganglia.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 There is no consensus among clinicians on the effectiveness of hyoscine-N-butyl bromide, as varying results have been reported by various authors. [15][16][17] During hysterosalpingography, there may be transient muscular spasm of the cornual portion of the fallopian tube, which is encased by the smooth muscle of the uterus, and this may be mistaken for true pathological obstruction of the proximal fallopian tube. 18 Cornual spasm is reversible but may persist for over 15 minutes.…”

Section: Introductionmentioning

confidence: 99%

Effect of addition of antispasmodic to local and systemic analgesics on pain perception during hysterosalpingography: a randomized controlled trial

et al. 2022

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Background: Tubal factor is responsible for most of the causes of infertility, especially in our environment, and hysterosalpingography (HSG) is the investigation of choice for assessing tubal patency. Objective of current study was to evaluate the effect of the addition of intramuscular hyoscine-N-butyl bromide (HBB) to local and systemic analgesics on pain perception during hysterosalpingography.Methods: This randomized controlled trial was conducted at the radiology departments and infertility clinics of four health institutions in Bayelsa State, Nigeria, from January 2020 to April 2022. One thousand and forty infertile women undergoing hysterosalpingography were randomized into four groups, and each group administered four different pain relief methods. Pain scores at different steps of the procedure were recorded. Data were analysed using the Statistical Product and Service Solutions for Windows®, version 25. Student’s t-test was used to compare sample means, while the chi-square test was used to compare the proportion of women in the two study groups, who expressed pain during the procedure.Results: The Paracervical block+HBB appeared to the most effective agent for pain relief in the study as women receiving this medication indicated the least pain intensity scores at all levels of the procedure except at the insertion of the speculum. The differences observed in the indicated pain intensity scores were also statistically significant (p<0.05).Conclusions: Our study revealed that adding HBB, an antispasmodic agent, to diclofenac and paracervical block significantly reduces pain perception during HSG compared to using diclofenac and paracervical block alone.

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Canadian Association of Gastroenterology (CAG) Position Statement on the Use of Hyoscine-n-butylbromide (Buscopan) During Gastrointestinal Endoscopy

Forbes

Frehlich

Borgaonkar

et al. 2021

Journal of the Canadian Association of Gastroenterology

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Hyoscine butylbromide, also known as hyoscyamine or scopolamine, and sold under the trade name Buscopan, is an antimuscarinic agent commonly used to induce smooth muscle relaxation and reduce spasmodic activity of the gastrointestinal (GI) tract during endoscopic procedures. However, the balance between desirable and undesirable (adverse) effects is not clear when used during GI endoscopy. The Clinical Affairs Committee of the Canadian Association of Gastroenterology (CAG) conducted systematic reviews and applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to develop recommendations for the use of Buscopan during GI endoscopy. To summarize, we recommend against the use of Buscopan before or during colonoscopy (strong recommendation, high certainty of evidence). We suggest against the use of Buscopan before or during gastroscopy (conditional recommendation, very low certainty of evidence). We suggest the use of Buscopan before or during ERCP (conditional recommendation, very low certainty of evidence). More research is needed to determine whether patients undergoing advanced procedures such as endoscopic mucosal resection or endoscopic submucosal dissection benefit from its use. Buscopan should be used with caution in patients with cardiac comorbidities. According to its product monograph, Buscopan is contraindicated in patients with tachycardia, angina, and cardiac failure. Thus, Buscopan should be used very cautiously in patients with these conditions, and only when the potential benefits of its use outweigh the potential risks in a particular case. Such patients require careful cardiac monitoring in an environment where resuscitation equipment and appropriately trained staff to use it are readily available. According to its product monograph, Buscopan is also contraindicated in patients with prostatic hypertrophy with urinary retention, and therefore, should be used very cautiously in such patients as well, and only when the potential benefits of its use outweigh the potential risks in a particular case. Obtaining a preprocedural history of glaucoma is unlikely to be of value when considering Buscopan use. However, in cases where Buscopan has been used, patients should be counselled postprocedurally and told to present to an emergency facility should they experience eye pain, redness, decreased vision, nausea and vomiting or headache.

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The effect of hyoscine-N-butylbromide on pain perception during and after hysterosalpingography in infertile women: a systematic review and meta-analysis of randomised controlled trials

Cited by 4 publications

References 28 publications

Effect of Intramuscular Hyoscine-N-Butyl Bromide on Tubal Spasm and Pain Perception in Women with Infertility Undergoing Hysterosalpingography: A Randomised Controlled Trial

Effect of Intramuscular Hyoscine-N-Butyl Bromide on Tubal Spasm and Pain Perception in Women with Infertility Undergoing Hysterosalpingography: A Randomised Controlled Trial

Effect of addition of antispasmodic to local and systemic analgesics on pain perception during hysterosalpingography: a randomized controlled trial

Canadian Association of Gastroenterology (CAG) Position Statement on the Use of Hyoscine-n-butylbromide (Buscopan) During Gastrointestinal Endoscopy

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