title: Rectal indomethacin use in pain relief during hysterosalpingography: A randomized placebo controlled trial.
abstract: OBJECTIVE
  To evaluate the effectiveness of a rectal nonsteroidal anti-inflammatory drug (indomethacin) for pain relief during a hysterosalpingography (HSG).
  
  
  METHODS
  This prospective, randomized study included 82 women divided randomly into two groups. The study group received self-administered rectal indomethacin, while the control group received a placebo before the procedure. Degrees of pain were evaluated using the visual analog scale (VAS) at four different steps during the procedure and 30 min afterwards. The anxiety-depression status of the patients was evaluated using a validated Turkish version of the Beck anxiety-depression form before the procedure.
  
  
  RESULTS
  There were no statistically significant differences in the demographic characteristics of patients. The mean pain scores during tenaculum application (step 2), cervical traction (step 3), contrast injection (step 4) and 30 min after the procedure, were significantly lower in the study than the control group (P < 0.05). Step 4 was the most painful in both groups (VAS scores 3.2 ± 0.6 study vs. 5.3 ± 1.1 control). The mean pain score in step 4 for patients with abnormal HSG results was significantly higher than in patients with normal HSG results (P < 0.05). The mean anxiety and depression scores immediately before the procedure were not statistically different between the groups (P = 0.610 and P = 0.129, respectively).
  
  
  CONCLUSIONS
  Our study demonstrated a significant reduction in pain in patients who received a single rectal dose of indomethacin; therefore, we recommend the use of rectal indomethacin for reducing pain during a HSG procedure.
authors.affiliation: School of Medicine, Department of Obstetric and Gynecology, Yuzuncu Yıl University, Van, Turkey.
authors.forename: Erbil
authors.initials: E
authors.lastname: Karaman
authors.affiliation: School of Medicine, Department of Obstetric and Gynecology, Yuzuncu Yıl University, Van, Turkey.
authors.forename: Numan
authors.initials: N
authors.lastname: Çim
authors.affiliation: School of Medicine, Department of Obstetric and Gynecology, Yuzuncu Yıl University, Van, Turkey.
authors.forename: İsmet
authors.initials: İ
authors.lastname: Alkış
authors.affiliation: School of Medicine, Department of Psychiatry, Yuzuncu Yıl University, Van, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Yıldırım
authors.affiliation: School of Medicine, Department of Obstetric and Gynecology, Yuzuncu Yıl University, Van, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Yıldızhan
mesh_terms: D000285:Administration, Rectal; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001007:Anxiety; D003863:Depression; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000009:adverse effects*; D007213:Indomethacin / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin
keywords: anxiety; hysterosalpingography; nonsteroidal anti-inflammatory drug; pain; visual analog scale