Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Objective: To compare between oral diclofenac potassium alone versus a combination of it with hyoscine-N-butyl bromide (HBB) in reducing pain in patients undergoing office hysteroscopy. Methods: A Randomized Double Blinded Placebo Controlled Trial study on 64 patients undergoing office hysteroscopy divided into 2 groups. Group I (combination group= 32 patients) received two oral HBB tablets (buscupan 10 mg, Boehringer Ingelheim) and one tablet of diclofenac potassium (Cataflam 50 mg , Novartis) and Group II (diclofenac only group= 32 patients) received two oral placebo tablet similar in size, structure and color to buscopan in addition to the diclofenac tablet.The patients were given the drugs 30-60 minutes before the procedure.Results:There was a statistically significant difference between the two groups in the pain score during entry (p value=0.001) and highly significant during the procedure (p value=<0.001) and after 30 mins of the procedure (p value=<0.001) in the combination group higher than the diclofenac only group.And also there was a statistically signifant difference in the side effects (gastric irritation) of the medications (p value=0.04) which is higher also in the combination group along between the women participated in the two groups. Conclusion: we concluded in our study that the combination of diclofenac potassium and HBB helps a lot in decreasing the pain and discomfort during and after performing office hysteroscopy but with more gastric side effects

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