The efficacy of oral naproxen and cervical lidocaine spray on perceived pain during hysterosalpingography

Objective: This study was carried out to evaluate the efficacy of the combined use of oral naproxen and cervical lidocaine spray during hysterosalpingography (HSG) compared to the use of oral naproxen or cervical lidocaine spray alone. Materials and Methods: This prospective randomised controlled study was carried out using a total of 240 patients who were randomly assigned to four groups. Group 1 received cervical lidocaine spray only, Group 2 received oral naproxen only, Group 3 received cervical lidocaine spray and naproxen tablet, whereas Group 4 was the control group. A visual analogue scale was used for subjective pain assessment at three pre-defined steps. Results: The mean pain scores of the patients in each of the four groups are Group 1 (3.6 +/- 2.0, 5.1 +/- 1.8, 5.8 +/- 2.2); Group 2 (2.7 +/- 1.4, 3.6 +/- 2.0 and 3.9 +/- 1.9); Group 3 (2.8 +/- 1.5, 3.4 +/- 2.0 and 4.2 +/- 2.3); Group 4 (4.7 +/- 1.7, 5.9 +/- 1.7 and 5.3 +/- 1.7) at T1, T2 and T3, respectively. Pain perception was statistically significantly reduced by naproxen and combined naproxen plus lidocaine spray at all the stages of HSG while cervical lidocaine spray had a statistically significant reduction in pain perception only during cervical instrumentation. Conclusion: Oral naproxen and combined naproxen plus cervical lidocaine spray were effective in reducing HSG-associated pain during all the stages of HSG. However, combined oral naproxen and lidocaine spray did not show superior efficacy over oral naproxen alone. Cervical lidocaine spray was not an effective method.