Effect of paracetamol as a prophylactic analgesic in infertile women undergoing hysterosalpingography in Bayelsa State, South-South Nigeria: a randomised controlled trial
DOI:
https://doi.org/10.18203/2349-3259.ijct20221109Keywords:
Hysterosalpingography, Pain, Paracetamol, Placebo, BayelsaAbstract
Background: Hysterosalpingography is the primary investigative modality of choice for the evaluation of the uterine cavity, fallopian tubes, and adjacent peritoneal cavity. Objective were to compare the effectiveness of paracetamol and placebo in pain reduction during hysterosalpingography.
Methods: This randomised controlled trial was conducted at the radiology departments and infertility clinics of the Federal Medical Centre, Yenagoa and Niger Delta University Teaching Hospital, Okolobiri, both in Bayelsa State, Nigeria, from February, 2021-July, 2021. Three hundred and eighty infertile women were assigned into two groups. Women in group I received paracetamol, while the women in group II received placebo. Data were analysed using statistical product and service solutions for Windows® version 25. Student’s t-test was used to compare sample means; and the Chi-square test was used to compare the proportion of women who expressed pain at the different steps of the procedure.
Results: Pain ratings among women in the placebo group were higher than those of women in the paracetamol group at all the stages of the procedure. The highest pain scores were recorded during the instillation of contrast media in both study groups, but higher in patients in the placebo group.
Conclusions: Our study revealed that paracetamol was superior to placebo in the control of hysterosalpingography-associated pain. However, pain scores high in the 2 groups during instillation of contrast media into uterine cavity.
References
Adeyemi AS, Adekanle DA, Afolabi AF. Pattern of gynaecological consultations at Ladoke Akintola University of Technology Teaching Hospital. Niger J Clin Pract. 2009;12(1):47-50.
Inhorn MC. Global infertility and the globalization of new reproductive technologies: Illustrations from Egypt. Soc Sci Med. 2003;56(9):1837-51.
Omo-Aghoja LA, Idrisa A. Infertility. In: Kwawukume EY, Ekele BA, Danso KA, Emuveyan EE, eds. Comprehensive Gynaecology in the Tropics. 2nd edition. Accra, Ghana: G-Pak limited; 2017:441-62.
The ESHRE Capri Workshop Group. Optimal use of infertility diagnostic tests and treatments. Hum Reprod. 2000;15:723-32.
Castillón G, Muñiz N, Simón C, Calaf-Alsina J. Clinical Evaluation of the Subfertile Female. In: Skinner MK, ed. Encyclopedia of Reproduction. Academic Press; 2018:2-8.
Kiridi EK, Oriji PC, Abasi IJ. Effect of pre-procedure anxiety levels on post-procedure pain scores in women undergoing hysterosalpingography in South-South Nigeria. Int J Trop Dis Health. 2022;43.
Graham GG, Davies MJ, Day RO, Mohamudally A, Scott KF. The modern pharmacology of paracetamol: therapeutic actions, mechanism of action, metabolism, toxicity and recent pharmacological findings. Inflammopharmacology. 2013;21(3):201-32.
Araoye MO. Subjects Selection. In: Research Methodology with statistics for Health and Social sciences. Ilorin. Nathadex publishers. 2003;115-29.
Menuba IE, Ugwu EO, Obi SN, Lawani LO, Onwuka CI. Clinical management and therapeutic outcome of infertile couples in southeast Nigeria. Ther Clin Risk Manag. 2014;10:763-8.
Yeung AWK, Wong NSM. The Historical Roots of Visual Analog Scale in Psychology as Revealed by Reference Publication Year Spectroscopy. Front Hum Neurosci. 2019;13.
Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA, Anderson JA. Studies with pain rating scales. Ann Rheum Dis. 1978;37(4):378-81.
Omidiji OA, Toyobo OO, Adegbola O, Fatade A, Olowoyeye OA. Hysterosalpingographic findings in infertility-what has changed over the years? Afr Health Sci. 2019;19(2):1866-74.
Kinci M, Yeşilçinar İ, Acavut G, Karasahin K. The opinions and thoughts of the women who had applied hysterosalpingography for the first time: Letter to editor. J Turk-Ger Gynecol Assoc. 2018;19.
Duffy JMN, Ahmad G, Watson AJS. Pain relief during hysterosalpingography: a national survey. Hum Fertil Camb Engl. 2008;11(2):119-21.
Jain S, Inamdar DB, Majumdar A, Jain DK. Effectiveness of paracervical block for pain relief in women undergoing hysterosalpingography. J Hum Reprod Sci. 2016;9(4):230-235.
Elson EM, Ridley NT. Paracetamol as a prophylactic analgesic for hysterosalpingography: a double blind randomized controlled trial. Clin Radiol. 2000;55(9):675-8.
Hindocha A, Beere L, O’Flynn H, Watson A, Ahmad G. Pain relief in hysterosalpingography. Cochrane Database Syst Rev. 2015;9.
Shaheed CA, Ferreira GE, Dmitritchenko A. The efficacy and safety of paracetamol for pain relief: an overview of systematic reviews. Med J Aust. 2021;214(7).
Unlu BS, Yilmazer M, Koken G, Arioz DT, Unlu E, Dogan Baki E. Comparison of four different pain relief methods during hysterosalpingography: a randomized controlled study. Pain Res Manag. 2015;20(2):107-11.
Robinson RD, Casablanca Y, Pagano KE, Arthur NA, Bates GW, Propst AM. Intracervical block and pain perception during the performance of a hysterosalpingogram: a randomized controlled trial. Obstet Gynecol. 2007;109(1):89-93.
Hacivelioglu S, Gencer M, Cakir Gungor A, Kosar S, Koc E, Cosar E. Can the addition of a paracervical block to systemic or local analgesics improve the pain perceived by the patient during hysterosalpingography? J Obstet Gynaecol J Inst Obstet Gynaecol. 2014;34(1):48-53.
Kiridi EK, Oriji PC, Ugwoegbu JU, Abasi IJ. Effectiveness of paracervical block for pain relief in women undergoing hysterosalpingography in Bayelsa State, South-South Nigeria: a randomized control trial. Int J Clin Trials. 2022;9(2).
Aduayi OS, Akanbi GO, Akintayo AA, Aduayi VA. Hysterosalpingography findings among women presenting for gynecological imaging in Ado-Ekiti, South western Nigeria. Int J Reprod Contracept Obstet Gynecol. 2017;5(6):1906-11.
Okafor CO, Okafor CI, Okpala OC, Umeh E. The pattern of hysterosalpingographic findings in women being investigated for infertility in Nnewi, Nigeria. Niger J Clin Pract. 2010;13(3):264-7.
Olatunji AA, Jagun OE, Toyobo OO, Ashaolu OA, Adekoya OA. Hysterosalpingogram findings among women with infertility in Ogun State, Nigeria. Ann Health Res. 2017;3(2):75-81.
Danfulani M, Haruna Y, Mohammed M, Ahmed S. Hysterosalphingographic findings in women with infertility in Sokoto North Western Nigeria. Afr J Med Health Sci. 2014;13:19.
Igoh EO, Chom ND, Pam SD, et al. Risk factors for abnormal tubal hysterosalpingographic findings in women presenting with infertility in Jos. Jos J Med. 2015;9(1):47-52.
Imo AOC, Sunday-Adeoye I. Radiological Assessment of The Uterus and Fallopian Tubes In Infertile Women At Abakaliki, Nigeria. Niger J Clin Pract. 2008;11(3):211-5.
Kiguli-Malwadde E, Byanyima RK. Structural findings at hysterosalpingography in patients with infertility at two private clinics in Kampala, Uganda. Afr Health Sci. 2004;4(3):178-81.
Kiridi EK, Oriji PC, Ugwoegbu JU, Abasi IJ. Hysterosalpingography Findings among Women Presenting for Infertility Evaluation in Bayelsa State, South-South Nigeria. J Adv Med Med Res. 2022;34(5):7-17.
Kiridi EK, Oriji PC, Abasi IJ, Ubom AE, Ugwoegbu JU. Predictors or abnormal findings in infertile women undergoing hysterosalgography in Bayelsa State, South-South Nigeria. Int J Clin Obstet Gynaecol. 2022;6.
Maheshwari A, Hamilton M, Bhattacharya S. Effect of female age on the diagnostic categories of infertility. Hum Reprod Oxf Engl. 2008;23(3):538-42.
Zain MM, Norman RJ. Impact of obesity on female fertility and fertility treatment. Womens Health Lond Engl. 2008;4(2):183-94.
Makwe CC, Ugwu AO, Sunmonu OH, Yusuf-Awesu SA, Ani-Ugwu NK, Olumakinwa OE. Hysterosalpingography findings of female partners of infertile couple attending fertility clinic at Lagos University Teaching Hospital. Pan Afr Med J. 2021;40:223.
Udobi S, Aronu M. Hysterosalpingographic findings in women with infertility in Awka, Anambra State, South-East Nigeria. Niger J Surg Sci. 2017;27(2):47-50.