Comparison of efficacy of oral drotaverine plus mefenamic acid with paracervical block and with intravenous sedation for pain relief during hysteroscopy and endometrial biopsy.

Background : Office hysteroscopy with endometrial biopsy is usually the first investigation for abnormal uterine bleeding and other uterine diseases. Aims: To evaluate the effect of oral drotaverine with mefenamic acid on pain perception during hysteroscopy and endometrial biopsy and to compare it with that of paracervical block using 1% lignocaine and with that of intravenous sedation using diazepam with pentazocine. Settings and Design : Outpatient gynecological department and open randomized trial. Materials and Methods : One hundred twenty women undergoing hysteroscopy and endometrial biopsy were randomized into 3 groups. Group I received tablet containing drotaverine hydrochloride (80 mg) + mefenamic acid (250 mg), group II received lignocaine paracervically and group III received intravenous diazepam. The intensity of pain during the procedure, 30 and 60 minutes later on visual analog scale (VAS) was assessed. Statistical Analysis : Statistical analysis was performed using Kruskal-Wallis test, with the Bonferroni correction, the t test, and the χ2 test. Results: Groups were similar in age, parity, vaginal birth or relevant medical history. A statistically significant difference in pain scores was noted among the 3 groups during the procedure (group I, 4.13± 1.28; group II, 5.93± 1.26; group III, 5.58± 1.51), (P< 0.001); as well as 30 minutes later (group I, 1.78± 0.89; group II, 2.53± 0.81; group III, 2.23± 0.94), (P< 0.001) and 60 minutes later (group I, 1.2± 0.46; group II, 1.98± 0.83; group III, 1.68± 0.75), (P< 0.001). VAS at different time intervals among the groups was also statistically significant. No adverse effects were observed. Conclusions : Oral drotaverine with mefenamic acid is effective in women undergoing hysteroscopy and endometrial biopsy.

Comparison of the effects of vitamin E and mefenamic acid on the severity of primary dysmenorrhea

Primary dysmenorrhea has relatively high incidence which can influence the well being and activities of the sufferers. An experimental cross-over study was designed to compare the effectiveness of vitamin E and mefenamic acid on reducing the severity of dysmenorrheal symptoms. Eighty six female medical students, aged between 18-26 who were suffering from primary dysmenorrhea were recruited. After having written consent they were divided into two groups of 43 individuals who received 500 units of vitamin E [2 tablets of 400 and 100 units] and 750mg mefenamic acid [250mg IDS] per day respectively. Treatment with vitamin E was started 2 days before the beginning of menstruation and continued until the first day of bleeding [3 days in total] and mefenamic acid was administered only during the first 48 hours of menstruation [only two days] Severity of pain, duration of bleeding, duration of menstruation and other symptoms such as diarrhea, secondary nausea, vomiting, vertigo, headache, legache, epigastric pain, pelvic pain before and after the treatment were recorded. Severity of pain was monitored by visual analogue scale [VAS] method on a visual scale. Monitoring was carried out for 2 consecutive cycles in both groups. Crossover was carried out and observation was continued for another 2 cycles. The result of this study indictate that both vitamin E and mefenamic acid could reduce the severity of pain similarly nevertheless but vitamin E consumption, complications such as digestive disorders such aspyrosis, stomach-ache, nausea and fatigue were significantly less compared to mefenamic acid. It appears that mefenamic acid could be replaced by vitamin E in reducing complications of dysmenorrhea

Tratamiento de la dismenorrea primaria: estudio comparativo de ibuprofen y ácido mefenámico / Treatment of primary dysmenorrhea: comparative study of ibuprofen and mefenamic acid

Se estudio el efecto terapéutico del ácido mefenámico (Grupo A) y del ibuprofen (Grupo B) en el tratamiento de la dismenorrea primaria severa. Se estudiaron 60 pacientes en base doble ciego en 2 grupos de 30 pacientes seleccionadas al azar. El grado inicial del dolor para el Grupo A fue de 8.6 y 8.5 para el primero y segundo ciclo y para el Grupo B de 8.2 en ambos ciclos. El tratamiento se inició en el momento en que se presentó el cólico menstrual y se administró una tableta del medicamento cada 8 horas durante el tiempo que duró el cólico menstrual. La intensidad del cólico menstrual se registró en la escala visual análoga (0 = no dolor, 10 = dolor incapacitante) en el momento del inicio del dolor y a las 2 horas de tomar la primera tableta del medicamento después de registró cada 8 horas antes de tomar la tableta correspondiente. La disminución del dolor se inició después de haber tomado la segunda tableta en ambos grupos siendo progresiva con el uso del medicamento. El número de tabletas tomadas fue en promedio 5.0 y 4.8 para el Grupo A y de 4.3 y 4.2 para el Grupo B. El promedio de la duración del dolor fue para el Grupo A 23.4 y 21 horas y para el Grupo B de 20 y 18.9 horas para el primero y segundo ciclos respectivamente