PMID- 36804576
OWN - NLM
STAT- MEDLINE
DCOM- 20230612
LR  - 20240111
IS  - 1553-4669 (Electronic)
IS  - 1553-4650 (Linking)
VI  - 30
IP  - 6
DP  - 2023 Jun
TI  - Efficacy of Oral Nifedipine, Naproxen, or Placebo for Pain Relief During 
      Diagnostic Hysteroscopy in an Office Setting: A Randomized Pilot Study.
PG  - 473-479
LID - S1553-4650(23)00058-4 [pii]
LID - 10.1016/j.jmig.2023.02.010 [doi]
AB  - STUDY OBJECTIVE: To compare nifedipine, naproxen, or placebo for pain relief 
      during diagnostic hysteroscopy. DESIGN: Double-blind, randomized controlled pilot 
      study. SETTING: University hospital. PATIENTS: Women scheduled for office 
      diagnostic hysteroscopy (n = 60). INTERVENTIONS: Women received nifedipine (2 
      tablets of 10 mg), naproxen (2 tablets of 250 mg), or placebo (2 tablets of 500 
      mg lactose) 30 to 60 minutes prior to hysteroscopy. MEASUREMENTS AND MAIN 
      RESULTS: Sixty patients were enrolled in the study (21 in the nifedipine group, 
      19 in the naproxen group, and 20 in the placebo group). The median pain scores 
      during hysteroscope insertion, measured on a Visual Analog Scale (VAS), were 1 
      (interquartile range (IQR) 0-0), 2 (0-4) and 1 (0-1) in the nifedipine, naproxen 
      and placebo group, respectively (P,14). The median VAS scores during hysteroscopy 
      were 5 (IQR 2-7), 5 (4-8) and 5 (3-7) in the nifedipine, naproxen and placebo 
      group, respectively (P,73). The median VAS scores immediately after hysteroscopy 
      were 2 (IQR 0-4), 3 (0-6) and 3 (1-5) in the nifedipine, naproxen and placebo 
      group, respectively (P,40). The median VAS scores 30 minutes after hysteroscopy 
      were 1 (IQR 0-2), 1 (0-1) and 1 (0-2) in the nifedipine, naproxen and placebo 
      group, respectively (P,63). Hysteroscope insertion failed in 1 case (naproxen 
      group) because of cervica;l stenosis (P,32). Flushes, fatigue and vertigo, 30 
      minutes after the procedure, were significantly more prevalent in the nifedipine 
      group compared to the naproxen (p < .001, p,03, p,03, respectively) and the 
      placebo group (p < .001, p,01, p,01, respectively). Palpitations occurred only in 
      the nifedipine group (p < .001). The day after the procedure, the headache was 
      most prevalent in the nifedipine group compared to the naproxen group (p,001) and 
      the placebo group (p,001). CONCLUSION: In our pilot study, pain relief and 
      success rates for office diagnostic hysteroscopy were not significantly different 
      between nifedipine, naproxen, and placebo. Nifedipine was associated with more, 
      albeit tolerable, side-effects.
CI  - Copyright (c) 2023 AAGL. Published by Elsevier Inc. All rights reserved.
FAU - van Wessel, Steffi
AU  - van Wessel S
AD  - Women's Clinic, Ghent University Hospital (Drs. Wessel, Rombaut, Vanhulle, 
      Hamerklynck, Weyers), Ghent, Belgium. Electronic address: 
      steffi.vanwessel@uzgent.be.
FAU - Rombaut, Julie
AU  - Rombaut J
AD  - Women's Clinic, Ghent University Hospital (Drs. Wessel, Rombaut, Vanhulle, 
      Hamerklynck, Weyers), Ghent, Belgium.
FAU - Vanhulle, Astrid
AU  - Vanhulle A
AD  - Women's Clinic, Ghent University Hospital (Drs. Wessel, Rombaut, Vanhulle, 
      Hamerklynck, Weyers), Ghent, Belgium.
FAU - Emanuel, Mark Hans
AU  - Emanuel MH
AD  - Women's Care, Bergman Clinics (Dr. Emanuel), Hilversum, Netherlands; Department 
      of Reproductive Medicine and Gynecology, University Medical Center (Dr. Emanuel), 
      Utrecht, The Netherlands.
FAU - Hamerlynck, Tjalina
AU  - Hamerlynck T
AD  - Women's Clinic, Ghent University Hospital (Drs. Wessel, Rombaut, Vanhulle, 
      Hamerklynck, Weyers), Ghent, Belgium.
FAU - Weyers, Steven
AU  - Weyers S
AD  - Women's Clinic, Ghent University Hospital (Drs. Wessel, Rombaut, Vanhulle, 
      Hamerklynck, Weyers), Ghent, Belgium.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20230216
PL  - United States
TA  - J Minim Invasive Gynecol
JT  - Journal of minimally invasive gynecology
JID - 101235322
RN  - 57Y76R9ATQ (Naproxen)
RN  - I9ZF7L6G2L (Nifedipine)
SB  - IM
MH  - Pregnancy
MH  - Humans
MH  - Female
MH  - *Naproxen/therapeutic use
MH  - *Hysteroscopy/methods
MH  - Pilot Projects
MH  - Nifedipine/therapeutic use
MH  - Double-Blind Method
MH  - Pain/etiology
OTO - NOTNLM
OT  - Diagnostic hysteroscopy
OT  - Efficacy
OT  - Naproxen
OT  - Nifedipine
OT  - Office hysteroscopy
OT  - Pain relief
EDAT- 2023/02/23 06:00
MHDA- 2023/06/12 06:42
CRDT- 2023/02/22 08:50
PHST- 2022/12/15 00:00 [received]
PHST- 2023/02/08 00:00 [revised]
PHST- 2023/02/10 00:00 [accepted]
PHST- 2023/06/12 06:42 [medline]
PHST- 2023/02/23 06:00 [pubmed]
PHST- 2023/02/22 08:50 [entrez]
AID - S1553-4650(23)00058-4 [pii]
AID - 10.1016/j.jmig.2023.02.010 [doi]
PST - ppublish
SO  - J Minim Invasive Gynecol. 2023 Jun;30(6):473-479. doi: 
      10.1016/j.jmig.2023.02.010. Epub 2023 Feb 16.