Analgesic effect of oral Hyoscine N Butyl Bromur in endometrial biopsy

Abstract

Objective: To investigate the efficacy of oral 10 mg Hyoscine N Butyl Bromur (HBB) on pain perception of the patients who underwent endometrial biopsy with Pipelle.

Material and Method: The charts of the patients who were 18-49 years and underwent endometrial biopsy with Pipelle for evaluation of abnormal uterine bleeding at xxxxxxxxxxxxxxxxxxxxxxxxxxxxx between September 2018 and September 2019 were retrospectively evaluated. 48 patients were seperated as HBB Group who used oral 10 mg HBB 30 minutes before endometrial biopsy and 56 patients as Control Group who did not used any pain relief medication before endometrial biopsy.  

Results: There were no statistically significant difference between two groups in age, BMI, parity, number of vaginal and cesarean births, nulliparity, multipartiy, and menopausal status. On the other hand, VAS (0) scores which were recorded immediately after endometrial biopsy and VAS (30) scores which were recorded 30 minutes after endometrial biopsy of the patients of the HBB Group were lower than the Control Group (59,3 ± 21,12 vs 86,42 ± 10.95, ve 19,09 ± 23,85 vs 55,71 ± 21,67 respectively; p≤0,001).

Conclusion: 10 mg oral HBB when taken 30 minutes before intervention, significantly decreases pain associated with Pipelle endometrial biopsy. This data might help to increase the endication spectrum of HBB for analgesic purposes in gynecology field.

Keywords

• Endometrial biopsy,Hyoscine N Butyl Bromur,pain,pipelle

Endometriyal biopsi işlemi öncesinde kullanılan oral Hyosine N Butil Bromur’ün analjezik etkinliği

Öz

Amaç: Bu çalışmanın amacı Pipelle ile yapılan endometrial biyopsi işlemi öncesinde oral yoldan alınan 10 mg Hyosine N Butil Bromur (HBB)’nin analjezik etkinliğini değerlendirmektir.

Gerek ve Yöntem: Eylül 2018- Eylül 2019 tarihleri arasında, xxxxxxxxxxxxx, anormal uterin kanamanın değerlendirilmesi için Pipelle ile endometriyal biyopsi yapılmış, 18-49 yaş arasındaki hastaların dosyaları retrospektif olarak incelendi. Endometriyal biyopsi işleminin 30 dakika öncesinde oral yoldan 10 mg HBB kullanan 48 hasta HBB Grubu, endometriyal biyopsi işlemi öncesinde hiçbir analjezik kullanmayan 56 hasta ise Kontrol Grubu olarak ayrıldı.

Bulgular: Yaş, vücut kitle indeksi, parite, vajinal ve sezaryen doğum sayısı, nulliparite, multiparite ve menopozal durum parametreleri açısından 2 grup arasında fark gözükmezken endometriyal biyopsinin hemen sonrasında kaydedilmiş VAS (0) ve endometriyal biyopsiden 30 dakika sonra kaydedilmiş olan VAS (30) skorları HBB Grubunda Kontrol Grubuna göre daha düşük saptandı (sırasıyla 59,3 ± 21,12 vs 86,42 ± 10.95, ve 19,09 ± 23,85 vs 55,71 ± 21,67; p≤0,001)

Sonuç: Endometriyal biyopsi işleminden 30 dakika önce oral yoldan alınan 10 mg HBB’nin, endometriyal biyopsi sırasında ve işlemden 30 dakika sonrasında analjezik etkinliği vardır. Bu data HBB’nin diğer jinekolojik endikasyonlar ile kullanımının yaygınlaşmasına yardımcı olabilir.

Anahtar Kelimeler

• Ağrı,Hyosine N Butil Bromur,Pipelle,endometriyal biyopsi

Kaynakça

1. 1. Cooper JM, Erickson ML. Endometrial sampling techniques in the diagnosis ofabnormal uterine bleeding. Obstet Gynecol Clin North Am 2000;27:235–442.
2. 2. Kazandi M, Okmen F, Ergenoglu AM, Yeniel AO, Zeybek B, Zekioglu O, Ozdemir N: Comparison of the success of histopathological diagnosis with dilatation-curettage and Pipelle endometrial sampling. J Obstet Gynaecol 2012;32:790–794.
3. 3. Demirkiran F, Yavuz E, Erenel H, Bese T, Arvas M, Sanioglu C: Which is the best technique for endometrial sampling? Aspiration (Pipelle) versus dilatation and curettage (D&C). Arch Gynecol Obstet 2012;286:1277– 1282.
4. 4. Dogan E, Celiloglu M, Sarihan E, Demir A: Anesthetic effect of intrauterine lidocaine plus naproxen sodium in endometrial biopsy. Obstet Gynecol 2004;103:347–351.
5. 5. Einarsson JI, Henao G, Young AE. Topical Analgesia for Endometrial Biopsy. Obstet Gynecol. 2005 Jul;106(1):128-30.
6. 6. Hui SK, Lee L, Ong C, Yu V, Ho LC: Intrauterine lignocaine as an anaesthetic during endometrial sampling: a randomised double-blind controlled trial. BJOG 2006;113:53–57.
7. 7. Acmaz G, Bayraktar E, Aksoy H, et al. Effect of paracetamol, dexketoprofen trometamol, lidocaine spray, pethidine and diclofenac sodium application for pain relief during fractional curettage: a randomized controlled trial. Indian J Med Res 2015;142:399–404
8. 8. Kirim S, Asicioglu O, Yenigul N, Aydogan B, Bahat N, Bayrak M. Effect of intravenous hyoscine-N-butyl bromide on active phase of labor progress: a randomized double blind placebo controlled trial. J Matern Fetal Neonatal Med. 2015;28(9):1038-1042.

9. 9. Sirohiwal D, Dahiya K, De M. Efficacy of hyoscine-n-butyl bromide (Buscopan) suppositories as a cervical spasmolytic agent in labour. Aust N Z J Obstet Gynaecol. 2005 Apr;45(2):128-9.
10. 10. Abbas AM, Abo-Elela NA, Mosa EM. Effect of oral hyoscine-Nbutyl bromide on pain perception during hysterosalpingography: A randomized, double-blind, placebo controlled trial. Middle East Fertil Soc J. 2018;23(1):57-62.
11. 11. Jareethum R, Suksompong S, Petyim S, Prechapanich J, Laokirkkiat P, Choavaratana R. Efficacy of mefenamic acid and hyoscine for pain Med J Islam Repub Iran. 2019 (16 Apr); 33.31.
12. 12. Safi F, Kamali A, Rezaei M, Rezaei M, Rafiei M. Effect of intramuscular hyoscine-n-butyl bromide on fallopian tube spasm and pain perception during and after hysterosalpingography in infertile women: A randomized single-blind controlled clinical trial. Med J Islam Repub Iran. 2019 Apr 16;33:31.
13. 13. Abbas AM, Samy A, El-Naser Abd El-Gaber Ali A et al. Medications for pain relief in outpatient endometrial sampling or biopsy: a systematic review and network meta-analysis. Fertil Steril. 2019 Jul;112(1):140-148.e12.
14. 14. Ouladsahebmadarek E, Gharabaghi PM, Behjati F, Azadi A, Seidhejazie M. Role of local anesthetics on pain relief in endometrial biopsy: randomized clinical trial. Int J Women’s Health Reprod Sci 2014;2:58–66.
15. 15. Aksoy H, Aksoy U, Ozyurt S, Ac € ¸maz G, Babayigit M. Lidocaine 10% spray to the cervix reduces pain during intrauterine device insertion: a double-blind randomised controlled trial. J Fam Plann Reprod Health Care 2016;42:83–7
16. 16. Korsuwan P, Wiriyasirivaj B. Lidocaine spray for pain control during office-based endometrial biopsy: a randomized placebo-controlled trial. Thai J Obstet Gynacol 2018;26:46–53.
17. 17. Trolice MP, Fishburne C, McGrady S. Anesthetic efficacy of intrauterine lidocaine for endometrial biopsy: a randomized double-masked trial. Obstet Gynecol 2000;95:345–7.
18. 18. Cengiz H, Daǧdeviren H, Kaya C, Ye¸ sil A, C¸ aypinar SS. Comparing the efficacy of intrauterine lidocaine and paracervical block in decreasing the pain associated with endometrial biopsy: a randomised trial. Arch Gynecol Obstet 2014;289:609–14.
19. 19. Poomtavorn Y, Phupong V: Prospective randomized, double-blinded, placebo-controlled trial of preoperative rofecoxib for pain relief in uterine curettage. Arch Gynecol Obstet 2005;273:115–118.
20. 20. Phittayawechwiwat W, Thanantaseth C, Ayudhya NI, O-Prasertsawat P, Kongprasert J: Oral etoricoxib for pain relief during fractional curettage: a randomized controlled trial. J Med Assoc Thai 2007;90:1053–1057.
21. 21. Manyou B, Phupong V: Prospective randomized, double-blinded, placebo-controlled trial of preoperative etoricoxib for pain relief in uterine fractional curettage under paracervical block. Eur J Obstet Gynecol Reprod Biol 2008;140:90–94.
22. 22. Sharma JB, Aruna J, Kumar P. Comparison of efficacy of oral drotaverine plus mefenamic acid with paracervical block and with intravenous sedation for pain relief during hysteroscopy and endometrial biopsy. Indian J Med Sci. 2009 Jun;63(6):244-52.