Histerosalpingografide Kullanılan İyotlu Kontrast Maddenin Vücut Sıcaklığında ya da Oda Sıcaklığında Uygulanmasının Vizüel Analog Skala Skorlarına Etkisi

Öz

Amaç: İnfertil hastalarda soğuk ve sıcak kontrast madde kullanılarak çekimi yapılan histerosalpingografi (HSG) işlemi sırasında ve sonrasında vizüel analog skalası (VAS) kullanarak ağrı skorlarını karşılaştırmak ve sıcak kontrast kullanımının spontan gebelik oranını değiştirip değiştiremeyeceğini araştırmak. Gereçler ve Yöntem: Çalışma prospektif randomize kontrollü tasarlandı ve Mart-Eylül 2017 tarihleri arasında HSG prosedürü uygulanan primer infertil hastalar dahil edildi. Hastaların yaşı, vücut kitle indeksi (VKİ), geçirilmiş cerrahi öyküsü, infertilite süresi ve en ağrılı adet dönemindeki ağrı düzeyleri kaydedildi. İşlem sırasında ve işlem sonrası 30. dakikada ağrı şiddeti VAS ile sorgulandı. Hastaların yaşı, vücut kitle indeksi (VKİ), geçirilmiş cerrahi öyküsü, infertilite süresi ve en ağrılı adet dönemindeki ağrı düzeyleri kaydedildi. İşlem sırasında ve işlem sonrası 30. dakikada ağrı şiddeti VAS ile sorgulandı. Bulgular: Gruplar arasında yaş, VKİ, infertilite süresi, geçirilmiş cerrahi ve menstrüasyon sırasındaki VAS açısından istatistiksel olarak anlamlı fark yoktu. Sıcak gruptaki hastaların ortalama HSG süresi anlamlı olarak daha düşüktü (p=0,001). Sıcak gruptaki hastaların HSG sırasındaki ve 30 dakika sonraki ortalama VAS skoru, kontrol grubuna göre (sırasıyla 5,3±4,2 vs 7,5±2,0) (1.1±0,9 ve 2,4±1,4) anlamlı derecede düşüktü. HSG sırasında şiddetli ağrı yüzdesi sıcak grupta %25.5 iken kontrol grubunda %66.7 idi. Lojistik regresyon analizinde, iki grup arasında işlem sırasında hissedilen şiddetli ağrı için yalnızca anlamlı ilişkili faktörler olarak bulundu (p<0,001, OR=0,19, %95 CI=0,08-0,46). Sonuç: HSG işlemi sırasında vücut sıcaklığında kontrast madde kullanılması işleme bağlı ağrıyı azaltır.

Anahtar Kelimeler

• Histerosalpingografi
• iyotlu kontrast madde
• pelvik ağrı
• sıcak kontrast madde

The Effect of Applying the Iodized Contrast Materials Used in Hysterosalpingography at Body Temperature or Room Temperature on Visual Analogue Scale Scores

Öz

Aim: To compare pain scores of infertile patients during and after hysterosalpingography (HSG) procedure using visual analoge scale (VAS) between cold and warm contrast medium and to investigate whether using warm contrast can alter spontaneous pregnancy rate. Materials and Methods: Prospective randomized study between March-September 2017. Primary infertile patients undergoing HSG procedure. Patients’ age, body mass index (BMI), history of previous surgery, duration of infertility and pain levels during the most painful menstrual period were recorded. The pain severity was questioned during and at the 30th minute after the procedure using VAS. While patients who underwent HSG using a contrast medium at body temperature 37 °C were defined as warm group(n:55), patients who underwent HSG using a contrast medium at room temperature 23 °C were defined as cold group (n:55). Results: There were no significant differences between the groups in terms of age, BMI, duration of infertility, previous surgery and VAS during menstruation. The mean duration of HSG of warm group patients was significantly lower(p=0.001). Warm group patients’ mean VAS score during and 30 minutes after HSG were significantly lower than in the control group ( 5.3±4.2 vs 7.5±2.0), (1.1±0.9 vs 2.4±1.4), respectively. While severe pain percentage during HSG in warm group was 25.5%, it was 66.7% in the control group. In logistic regression analysis, warm and cold groups were only found as significant related factors for severe pain felt during procedure (p<0.001, OR=0.19, 95% CI=0.08-0.46). Conclusion: The use of contrast media at body temperature during HSG procedure reduces the pain associated with the procedure.

Anahtar Kelimeler

• Hysterosalpingography
• iodinated contrast media
• pelvic pain warm contrast media
• visual analogue scale.

Kaynakça

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