Paracetamol as a prophylactic analgesic for hysterosalpingography: A double blind randomized controlled trial

AIM: To evaluate the effectiveness of paracetamol as a prophylactic analges ic for hysterosalpingography (HSG). DESIGN: A prospective double blind randomized controlled trial comparing on e 1 g of paracetamol (SmithKline Beecham, Brentford, U.K.) to placebo taken 30 min before HSG. One hundred consecutive out-patients were studied prosp ectively, The analgesic effectiveness during the procedure and at 24 h and 1 week post procedure was analysed by a postal pain score questionnaire, Ad ditional data on the ethnicity of the patient, sex and level of experience of the radiologist performing the hysterosalpingogram, the parity of the pa tient, the ease of the procedure, and whether pathology was Identified were also recorded. RESULTS: Eighty-eight patients (88%) replied, 39 (44%) received paracetamol and 39 placebo (56%), During the procedure 3/39 (7%) of women in the parac etamol group were pain-fret compared to 9/49 (18%) in the placebo group, wh ich was not significant (P = 0.11). At 24 h, 15/39 (38%) of women in the pa racetamol group were pain-free compared to 20/49 (41%) in the placebo group , which was not significant (P = 0.82), At 1 week, 27/39 (69%) of women in the paracetamol group were pain-free compared to 29/49 (59%) in the placebo group, which was not significant (P = 0.33). No significant difference in mean pain stores was determined during the procedure (P = 0.91), or at 24 h post procedure (P = 0.94). Similarly, no difference in mean pain scores wa s identified with regard to the ethnicity of the patient, the sex of the ra diologist performing the procedure, the level of experience of the radiolog ist performing the procedure, or whether pathology was present or not. Diff icult cannulations were associated with higher mean pain scores, however, t here was no difference in mean pain scores between the paracetamol or place bo groups for both easy and difficult cannulations. CONCLUSION: Paracetamol is not effective as a prophylactic analgesic for HS G. If a prophylactic analgesic is considered necessary for pain relief duri ng HSG we recommend that a non-steriodal anti-inflammatory drug: (NSAID) is used. (C) 2000 The Royal College of Radiologists.