Effect of oral diclofenac potassium plus cervical lidocaine cream on pain perception during hysterosalpingography: A randomized, double-blind, placebo-controlled trial

Abstract

Objective: The current study aims to investigate the analgesic effect of combining oral diclofenac potassium and cervical lidocaine cream for alleviating pain during HSG. Study design: A randomized double-blind controlled trial. Setting: Assiut University Hospital, Assiut, Egypt. Materials and methods: Reproductive-aged infertile women scheduled for HSG were recruited and randomized (1:1) to diclofenac plus lidocaine or Placebo group. All women received oral 50 mg diclofenac potassium or placebo tablets one hour before HSG, then 3 ml of lidocaine 5% cream or placebo was applied to the anterior cervical lip, followed by 3 ml placed in the cervical canal using a sterile needless syringe. The study outcomes was the participant’s self-rated pain perception utilizing a 10-cm Visual Analogue Scale (VAS) during speculum placement, cervical tenaculum placement, injection of the dye, 5 min and 30 min post-procedure. Results: One hundred forty women were enrolled (n = 70 in each group). Oral diclofenac plus lidocaine cream significantly reduce the median VAS pain scores during injection of the dye (4 vs. 7), 5 min post-procedure (2 vs. 4) and 30 min post-procedure (1 vs. 2.5) with p = 0.0001 at all steps. No significant differences in VAS score after speculum or tenaculum placement. Conclusions: Utility of oral diclofenac potassium one hour before HSG combined with cervical lidocaine 5% cream significantly alleviate the induced pain during and 30 min after the HSG procedure.

Keywords

• Hysterosalpingography
• Lidocaine
• NSAIDs
• Pain relief
• Diclofenac