Effect of topical xylocaine for pain relief during hysterosalpingography among infertile women in Zaria, Nigeria: A randomized controlled trial

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Anisah Yahya
Hajara Umaru‑Sule
Aminatu Makarfi Umar
Halima Mono Muhammad
Philip Oluleke Ibinaiye

Abstract

Background/Aim: Hysterosalpingography (HSG) is a radiological procedure that is used to assess the patency  of the female genital tract. It is a routine procedure for evaluating female factor infertility in our environment  where the incidence of tubal factor infertility is high. It is associated with varying degrees of discomfort and pain. The study aimed at comparing the efficacy of topical analgesia to a placebo for providing pain relief in women undergoing HSG as workup for infertility.
Subjects and Methods: The study was a double-blind, parallel group randomized controlled trial of 117  infertile women who had HSG at the Ahmadu Bello University Teaching Hospital, Zaria, from February  to December 2019. The intervention group (n = 59) and the control (n = 58) had 15 ml of 2% xylocaine gel and 15 ml of K-Y jelly (placebo) applied directly on their uterine cervical lip, respectively. The primary outcome measure was the mean Visual Analog Scale (VAS) for pain perception on each group during HSG at the point of cervical manipulation and uterine filling with contrast.
Results: The mean VAS scores for pain perception in the xylocaine group during cervical manipulation and uterine filling were 2.3 (0.24) and 3.5 (0.35), respectively, while the scores for the placebo group during cervical manipulation and uterine filling were 7.1 (1.8) and 5.5 (0.32), respectively. The observed difference was statistically significant (P ≤ 0.001).
Conclusion: During HSG of infertile women in Zaria, Nigeria, the use of topical xylocaine on the uterine cervix was associated with decreased pain perception during cervical manipulation and uterine filling with contrast when compared to placebo.
“Trial registry: Www.clinicaltrials.gov, Identifier NCT03802032.”

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Yahya, A., Umaru‑Sule, H., Umar, A. M., Muhammad, H. M., & Ibinaiye, P. O. (2021). Effect of topical xylocaine for pain relief during hysterosalpingography among infertile women in Zaria, Nigeria: A randomized controlled trial. West African Journal of Radiology, 28(1), 8-14. https://doi.org/10.4103/wajr.wajr_9_20

References

1. Idrisa A, Ojiyi E. Pattern of infertility in Northeastern Nigeria. Trop J Obs Gynaecol 2000;17:27‑9.

2. Adesiyun AG, Ameh CA, Eka A. Hysterosalpingographic tubal abnormalities and HIV infection among black women with tubal infertility in sub‑Saharan Africa. Gynecol Obstet Invest 2008;66:119‑22.

3. Foroozanfard F, Sadat Z. Diagnostic value of hysterosalpingography and laparoscopy for tubal patency in infertile women. Nurs Midwifery

Stud 2013;2:188‑92.

4. Kalantari M, Zadeh Modares S, Ahmadi F, Hazari V, Haghighi H, Chehrazi M, et al. Randomized double‑blind clinical trial of eutectic mixture of local anesthetic creams in reducing pain during hysterosalpingography. Iran J Radiol 2014;11:e10513.

5. Park A, Quaas AM, Hansen KR, Porter B, Burks H, Craig LB. Predictors of pain associated with hysterosalpingography (HSG):

A prospective cohort study. Austin J Womens Heal 2014;1:4.

6. Hindocha A, Beere L, O’Flynn H, Watson A, Ahmad G. Pain relief in hysterosalpingography. Cochrane Database of Systematic Reviews

2015. Art. No.: CD006106.DOI: 10.1002/14651858.CD006106.pub3.

7. Unlu BS, Yilmazer M, Koken G, Arioz DT, Unlu E, Dogan Baki E, et al. Comparison of four different pain relief methods during

hysterosalpingography: A randomized controlled study. Pain Res Manag 2015;20:107‑11.

8. Frishman GN, Spencer PK, Weitzen S, Plosker S, Shafi F. The use of intrauterine lidocaine to minimize pain during hysterosalpingography:

A randomized trial. Obstet Gynecol 2004;103:1261‑6.

9. Costello MF, Horrowitz S, Steigrad S, Saif N, Bennett M, Ekangaki A. Transcervical intrauterine topical local anesthetic at hysterosalpingography: A prospective, randomized, double‑blind, placebo‑controlled trial. Fertil Steril 2002;78:1116‑22

10. Bachman EA, Senapati S, Sammel MD, Kalra SK. Randomized controlled trial of benzocaine versus placebo spray for pain relief at

hysterosalpingogram. Reprod Biomed Online 2014;28:748‑52.

11. Wang YL, Gao HX, Wang JS, Wang JH, Bo L, Zhang TT, et al. Immersive virtual reality as analgesia for women during hysterosalpingography: Study protocol for a randomized controlled trial. Trials 2020;21:102.

12. Hoffmann B. Well Woman Care. In Williams Gynecology. 3rd ed. New York: McGraw Hill; 2016. p. 4‑5.

13. Rajashanker B. Reproductive system. In Chapman and Nakielny’s Guide to Radiological Procedures. 6th ed. Edinburgh: Elsevier. 2016. p. 159‑62.

14. Katz J, Melzack R. Measurement of pain. Surg Clin North Am 1999;79:231‑52.

15. Yahya A, Adesiyun A, Giwa F, Olorukooba AA. Seroprevalence and clinical correlates of human immunodeficiency virus infection

among women with infertility in northwestern Nigeria. Trop J Obstet Gynaecol 2018;35:177‑83.

16. Liberty G, Gal M, Halevy‑Shalem T, Michaelson‑Cohen R, Galoyan N, Hyman J, et al. Lidocaine‑prilocaine (EMLA) cream as analgesia for

hysterosalpingography: A prospective, randomized, controlled, double blinded study. Hum Reprod 2007;22:1335‑9.

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