The effect of preemptive intravenous ibuprofen for pain relief during hysterosalpingography in women with infertility: A randomized, double-blind controlled study

Abstract

Objectives: HSG is an invasive diagnostic procedure that involves the radiographic evaluation of the genital system after the injection of a radiopaque substance from the cervical canal in infertile women. Preemptive intravenous ibuprofen is commonly used for postoperative pain management. However, only a limited number of studies have reported the intravenous use of ibuprofen for short-term painful procedures. This study aimed to investigate the effectiveness of intravenous ibuprofen for pain management during HSG. Materials and methods: A total of 91 patients planned to undergo HSG due to infertility were included in the prospective, randomized, double-blind study. Patients were assigned into two groups: the ibuprofen group (group I, n = 43) and the control group (group C, n = 48). About 30 min before the procedure, 800 mg ibuprofen in 100 ml saline infusion was administered to the ibuprofen group, whereas 100 ml saline infusion was administered to the control group 30 min before the starting the procedure. Pain scores using a visual analog scale (VAS) during the procedure were evaluated at four-stage; (1) insertion of the speculum (2) holding and traction (3) administration of contrast matter; and (4) 30 min after the procedure. Besides, the patients were evaluated according to a scale with a range of 1–4 in terms of satisfaction. Results: There was no statistically significant difference in terms of demographic data (p>0.05). VAS pain scores in the median (25%-75%) during the administration of contrast agent were lower in group ibuprofen (median, 1; range 1-2) than in group control (median, 5.5; range 5-6) (p<0.001). There was no statistically significant difference between groups in terms of pain scores other stages of HSG (p>0.05). Patient satisfaction was significantly higher in group ibuprofen than in group control (p<0.001). Conclusion: Intravenous ibuprofen can be administered as an alternative approach to decrease pain and increase patient satisfaction in the HSG procedure performed under outpatient conditions. In conclusion; to the best of our knowledge, this is the first study that administered intravenous ibuprofen in the HSG procedure. However, further studies are needed to compare its effectiveness.