Elson E M, Ridley N T
Department of Radiology, Northwick Park and St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, U.K.
Clin Radiol. 2000 Sep;55(9):675-8. doi: 10.1053/crad.2000.0563.
To evaluate the effectiveness of paracetamol as a prophylactic analgesic for hysterosalpingography (HSG).
A prospective double blind randomized controlled trial comparing one 1 g of paracetamol (SmithKline Beecham, Brentford, U.K.) to placebo taken 30 min before HSG. One hundred consecutive out-patients were studied prospectively. The analgesic effectiveness during the procedure and at 24 h and 1 week post procedure was analysed by a postal pain score questionnaire. Additional data on the ethnicity of the patient, sex and level of experience of the radiologist performing the hysterosalpingogram, the parity of the patient, the ease of the procedure, and whether pathology was identified were also recorded.
Eighty-eight patients (88%) replied, 39 (44%) received paracetamol and 49 placebo (56%). During the procedure 3/39 (7%) of women in the paracetamol group were pain-free compared to 9/49 (18%) in the placebo group, which was not significant (P = 0.11). At 24 h, 15/39 (38%) of women in the paracetamol group were pain-free compared to 20/49 (41%) in the placebo group, which was not significant (P = 0.82). At 1 week, 27/39 (69%) of women in the paracetamol group were pain-free compared to 29/49 (59%) in the placebo group, which was not significant (P = 0.33). No significant difference in mean pain scores was determined during the procedure (P = 0.91), or at 24 h post procedure (P = 0.94). Similarly, no difference in mean pain scores was identified with regard to the ethnicity of the patient, the sex of the radiologist performing the procedure, the level of experience of the radiologist performing the procedure, or whether pathology was present or not. Difficult cannulations were associated with higher mean pain scores, however, there was no difference in mean pain scores between the paracetamol or placebo groups for both easy and difficult cannulations.
Paracetamol is not effective as a prophylactic analgesic for HSG. If a prophylactic analgesic is considered necessary for pain relief during HSG we recommend that a non-steroidal anti-inflammatory drug (NSAID) is used.
评估对乙酰氨基酚作为子宫输卵管造影术（HSG）预防性镇痛药的有效性。
一项前瞻性双盲随机对照试验，比较在HSG前30分钟服用1克对乙酰氨基酚（英国布伦特福德的史克必成公司生产）与服用安慰剂的效果。对100名连续的门诊患者进行前瞻性研究。通过邮寄疼痛评分问卷分析术中、术后24小时及1周时的镇痛效果。还记录了患者的种族、实施子宫输卵管造影术的放射科医生的性别和经验水平、患者的产次、手术的难易程度以及是否发现病理情况等额外数据。
88名患者（88%）回复，39名（占44%）服用对乙酰氨基酚，49名（占56%）服用安慰剂。术中，对乙酰氨基酚组3/39（7%）的女性无痛，而安慰剂组为9/49（18%），差异无统计学意义（P = 0.11）。术后24小时，对乙酰氨基酚组15/39（38%）的女性无痛，安慰剂组为20/49（41%），差异无统计学意义（P = 0.82）。术后1周，对乙酰氨基酚组27/39（69%）的女性无痛，安慰剂组为29/49（59%），差异无统计学意义（P = 0.33）。术中（P = 0.91）及术后24小时（P = 0.94）平均疼痛评分无显著差异。同样，在患者种族、实施手术的放射科医生性别、实施手术的放射科医生经验水平或是否存在病理情况方面，平均疼痛评分也无差异。插管困难与较高的平均疼痛评分相关，然而，对于插管容易和困难的情况，对乙酰氨基酚组和安慰剂组的平均疼痛评分均无差异。
对乙酰氨基酚作为HSG的预防性镇痛药无效。如果认为在HSG期间缓解疼痛有必要使用预防性镇痛药，我们建议使用非甾体抗炎药（NSAID）。
