Hyoscine butylbromide in pain reduction associated with ultrasound-guided manual vacuum aspiration: a randomized placebo-controlled trial.

Abstract

RESEARCH QUESTION:

What is the effect of adding an anti-spasmodic drug to an existing ultrasound-guided manual vacuum aspiration (USG-MVA) protocol to alleviate immediate post-procedure abdominal cramping pain in women treated for early pregnancy loss?

DESIGN:

Double-blind, placebo-controlled, randomized controlled trial conducted between February 2018 and January 2020. Participants were assigned to receive a 1-ml intravenous injection containing 20-mg hyoscine butylbromide (HBB) (n=55) or saline (n =56) as a control immediately before USG-MVA. Primary outcome was reduced abdominal pain after adding a 20-mg dose of HBB to the current pain control regimen. Secondary outcomes were vaginal pain, complications and side-effects, women's pre- and post-procedure psychological state, physiological stress (saliva alpha-amylase) and procedure pain control satisfaction. Two-way mixed ANOVA was used to evaluate the main effects and interactions.

RESULTS:

VAS abdominal pain scores in the HBB group were 16% lower immediately after and 21% lower 2 h after surgery (not statistically significant). Two-way ANOVA indicated that time (F[1108] = 83.41, P < 0.001) was the only significant main effect for reduced abdominal pain after the procedure and vaginal pain score (F[1108] = 180.1, P < 0.0001) but not drug received. No adverse events were reported. No significant difference was found for psychological state, physiological stress and procedure pain control satisfaction between the two groups.

CONCLUSIONS:

Anti-spasmodic drugs can help to reduce abdominal cramping pain associated with USG-MVA; HBB produced an insignificant decrease in abdominal pain score. Further studies with longer acting or larger doses of anti-spasmodic drugs are warranted.

• Authors: Jacqueline Pui Wah Chung, Tracy Sze Man Law, Jennifer Sze Man Mak, Rebecca Chui Yiu Liu, Daljit Singh Sahota, Tin Chiu Li
• Journal: Reproductive biomedicine online (Reprod Biomed Online) Vol. 44 Issue 2 Pg. 295-303 (02 2022) ISSN: 1472-6491 [Electronic] Netherlands
• PMID: 34949538 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2021 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Hydrocarbons, Brominated
• Butylscopolammonium Bromide
• Scopolamine
• butyl bromide

Topics

• Abdominal Pain (chemically induced, drug therapy)
• Butylscopolammonium Bromide (adverse effects, therapeutic use)
• Double-Blind Method
• Female
• Humans
• Hydrocarbons, Brominated
• Pregnancy
• Scopolamine (therapeutic use)
• Ultrasonography, Interventional
• Vacuum Curettage