PAIN RELIEF FOLLOWING DAY-CASE DIAGNOSTIC HYSTEROSCOPY-LAPAROSCOPY FOR INFERTILITY - A DOUBLE-BLIND RANDOMIZED TRIAL WITH PREOPERATIVE NAPROXEN VERSUS PLACEBO

Objective: To study the effects of preoperative naproxen on postoperat ive and post-discharge outcome and consumption of analgesics in patien ts undergoing diagnostic hysteroscopy and laparoscopy for infertility. Methods: A double-blind, placebo-controlled study was conducted in 60 healthy women scheduled for day-case hysteroscopy and laparoscopy. Su bjects were randomized to receive either 500-mg naproxen suppositories (n = 30) or placebo (n = 30) preoperatively. Following discharge, eac h patient was given two naproxen suppositories for treatment of pain a t home. Pain was scored on the Visual Analogue Scale, and the postoper ative and post-discharge use of analgesics was determined, recorded, a nd analyzed. Results: Patients premedicated with naproxen had signific antly less postoperative pain, showed more rapid ambulation, could be discharged earlier, and had less post-discharge pain. On the day after surgery, only six of 28 naproxen-treated patients needed analgesics, compared to 18 of 30 placebo patients. Conclusion: Day-case diagnostic hysteroscopy and laparoscopy for evaluation of infertility is potenti ally painful and stressful. Preoperative naproxen contributed to posto perative pain prevention, reduced hospital stay and consumption of ana lgesics, and shortened the period of post-discharge abdominal discomfo rt.