Pain relief following day-case diagnostic hysteroscopy-laparoscopy for infertility: a double-blind randomized trial with preoperative naproxen versus placebo.

Objective: To study the effects of preoperative naproxen on postoperative and post-discharge outcome and consumption of analgesics in patients undergoing diagnostic hysteroscopy and laparoscopy for infertility.
Methods: A double-blind, placebo-controlled study was conducted in 60 healthy women scheduled for day-case hysteroscopy and laparoscopy. Subjects were randomized to receive either 500-mg naproxen suppositories (n = 30) or placebo (n = 30) preoperatively. Following discharge, each patient was given two naproxen suppositories for treatment of pain at home. Pain was scored on the Visual Analogue Scale, and the postoperative and post-discharge use of analgesics was determined, recorded, and analyzed.
Results: Patients premedicated with naproxen had significantly less postoperative pain, showed more rapid ambulation, could be discharged earlier, and had less post-discharge pain. On the day after surgery, only six of 28 naproxen-treated patients needed analgesics, compared to 18 of 30 placebo patients.
Conclusion: Day-case diagnostic hysteroscopy and laparoscopy for evaluation of infertility is potentially painful and stressful. Preoperative naproxen contributed to postoperative pain prevention, reduced hospital stay and consumption of analgesics, and shortened the period of post-discharge abdominal discomfort.