For outpatient hysteroscopy (OH), it is recommended to take a standard dose of NSAIDs or more hyoscine-n butyl bromide (HBB) an hour prior to the procedure to minimize pain during the first postoperative hour. As there is currently no clear consensus in the literature regarding the best approach to pain management associated with office hysteroscopy procedures. This Phase 4 study is being conducted to evaluate the effectiveness of oral ibuprofen alone and in combination with HBB to determine the most appropriate strategy for improving pain perception in outpatients.
female patients older than 18 years who signed informed consent;
patients who need an office hysteroscopy for their diagnosis or treatment. Those indications included postmenopausal endometrial thickening (over 4 mm), metrorrhagia, sonographic suspicion of endometrial polyps or myomas, Essure device insertion, and endometrial biopsy
women with a possible pregnancy, ongoing vaginal bleeding, lower genital tract infection, gestational trophoblastic disease, asthma, hepatitis, renal failure, lactation, previous cervical surgery, or oversensitivity to one of the agents or their elements;
patients suffering from neuropathic pain or other conditions that can impact on the perception of pain;
individuals who use antidepressant, anxiolytics or other drugs/supplements that may have an impact on the perception of pain;
contraindications to the use of ibuprofen and/or Hyoscine N-Butil Bromide .
Parallel
Ibuprofen 400 mg
DrugIbuprofen 400 mg tablet
Hyoscine N-Butil Bromide
DrugHyoscine N-Butil Bromide 10 mg two tablets
placebo
DrugTwo tablets
Pain assessed by visual analog pain score (10-point VAS, where 0 indicates no pain and 10 indicates the worst possible pain)
The primary objective of this study is to determine the effectiveness of the use of ibuprofen 400 mg alone or a combination of 400 mg ibuprofen and 20 mg Hyoscine N-Butil Bromide, one hour before office hysteroscopy, has a different impact on reducing pain in patients.
Visual analog pain score for pain assessment (10-point VAS, where 0 indicates no pain and 10 indicates the worst possible pain)
To assess a different response to analgesic treatment between nullipare and multipare
Use of Visual analog pain score (10-point VAS, where 0 indicates no pain and 10 indicates the worst possible pain)
To evaluate response in post menopausal condition
Measure of the level of anxiety (through STAI-Y1 items, with a score from 1 to 4, where: 1 = not at all and 4 = very much)
Measure of the level of pre-procedural anxiety through the STAI-Y (scoring range: 20-80; cut-off: 39-40)
Rate of adverse effects (percentage of events collected)
Determine the safety profile of the study medications
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