Safi Fatemeh, Kamali Alireza, Rezaei Marzieh, Rezaei Mahboubeh, Rafiei Mohammad
Department of Radiology and Radiotherapy, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
Department of Anesthesiology, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
Med J Islam Repub Iran. 2019 Apr 16;33:31. doi: 10.34171/mjiri.33.31. eCollection 2019.
Hysterosalpingography plays an important role in diagnostic work-up and treatment planning for infertile women. This procedure is usually uncomfortable and painful. The present study plans to investigate the effect of intramuscular Hyoscine-N-Butyl Bromide (HBB) on fallopian tube spasm and pain perception during and after hysterosalpingography (HSG) in infertile women. This randomized single-blind controlled clinical trial (IRCT2017021132455N2) was conducted on infertile women scheduled for HSG in one radiology clinic affiliated to Arak University of Medical Sciences between July and August 2017. Patients were selected by convenience sampling and were randomly assigned to HBB (n=50) and a control group (n=50). Women received 20 mg/1cc HBB intramuscularly in the intervention group, 30 minutes before the procedure. Women in the control group did not receive any medication. The patients were requested to complete the Numeric Pain Rating Scale after injection of the dye, and also 30 minutes following the end of the HSG. Presence or absence of tubal spasm was determined after checking the radiographic images. For the data analysis using SPSS version 18, descriptive statistics, and analytical tests such as independent sample t-test, Mann- Whitney test, chi-square or Fisher's exact tests and logistic regression and ANCOVA were used. Statistically significant differences were not observed in pain scores between the HBB and the control groups at the point of dye injection and 30 minutes after ending the HSG (p>0.05). Also, tubal spasm in the HBB group was lower than in the control group, but the differences were not statistically significant between the two groups (p=0.37). The use of intramuscular HBB before HSG has no advantage in reducing tubal spasm and the induced pain during dye injection and 30 minutes after the HSG procedure. Thus, we don't recommend HBB use before the HSG in order to relief from pain and spasm.
子宫输卵管造影术在不孕女性的诊断检查和治疗规划中发挥着重要作用。该检查过程通常会让人感到不适和疼痛。本研究计划调查肌肉注射丁溴东莨菪碱（HBB）对不孕女性子宫输卵管造影术（HSG）期间及术后输卵管痉挛和疼痛感知的影响。这项随机单盲对照临床试验（IRCT2017021132455N2）于2017年7月至8月在阿拉克医科大学附属的一家放射科诊所中，对计划进行HSG的不孕女性开展。通过便利抽样选择患者，并将其随机分为HBB组（n = 50）和对照组（n = 50）。干预组女性在检查前30分钟肌肉注射20mg/1cc的HBB。对照组女性未接受任何药物治疗。要求患者在注射造影剂后以及HSG结束后30分钟完成数字疼痛评分量表。在检查X光图像后确定是否存在输卵管痉挛。使用SPSS 18版进行数据分析，采用描述性统计以及独立样本t检验、曼 - 惠特尼检验、卡方检验或费舍尔精确检验、逻辑回归和协方差分析等分析测试。在注射造影剂时以及HSG结束后30分钟，HBB组和对照组之间的疼痛评分未观察到统计学上的显著差异（p>0.05）。此外，HBB组的输卵管痉挛低于对照组，但两组之间的差异无统计学意义（p = 0.37）。在HSG前使用肌肉注射HBB在减少输卵管痉挛以及造影剂注射期间和HSG术后30分钟引起的疼痛方面并无优势。因此，我们不建议在HSG前使用HBB来缓解疼痛和痉挛。
