Oral diclofenac potassium and intramuscular hyoscine-n-butyl bromide versus oral diclofenac potassium alone for pain relief during hysterosalpingography: a double blind randomized controlled trial

Hysterosalpingography (HSG) is an important diagnostic tool in infertility, often associated with pain and tubal spasms, potentially resulting in false proximal tubal occlusions. This randomised controlled trial compared oral diclofenac potassium plus intramuscular hyoscine-N-butyl bromide (HBB) with oral diclofenac alone in 138 women undergoing HSG at Central Hospital, Warri. Pain perception, the primary outcome, was assessed using the Visual Analogue Scale (VAS). Secondary outcomes were tubal spasm, patient satisfaction, and adverse effects. Baseline characteristics were similar across the groups. Median VAS scores were not significantly different immediately after HSG (3 vs. 4, P = 0.126) or at 30 minutes post-procedure (1 vs. 2, P = 0.083). No significant differences were found in tubal spasm rates (P = 0.526), satisfaction scores (P = 0.054), and Dizziness (26.1%, P = 0.062). The addition of intramuscular HBB to diclofenac potassium did not confer improved outcomes and was associated with more side effects.