Preemptive analgesia for primary dysmenorrhea : A randomized controlled clinical trial

Abstract

Background: Spasmodic dysmenorrhea is one of the commonest painful attacks that affects young ladies. Non steroidalanti-inflammatory (NSAID) drugs are considered as one of the main treatment options. Different pain management modalities concern with pretreatment with analgesia before the painful stimuli that defined as preemptive analgesia.Aim: This study aimed to evaluate the possible effect of administration of NSAIDs before the onset of pain in the anticipating menstrual cycle.  Materials and Methods: One hundered young ladies ranged from 15-25 years old were randomly divided into two groups. Group 1 received mefinamic acid 2 days before the anticipating date of menstruation and continued throughout the first 2 days of menstruation and group 2 received the same medication however started with the onset of symptoms only.  Results: Both groups were comparable regarding age, education and menstrual characters. The average pain score was nearly the same in both groups (8.78 ± 1.07 and 8.66 ± 1.04) and it was significantly decrease after intervention in both groups. The decrease in pain score was more in the girls treated before menstruation (4.24 ± 1.57) compared to (7.20 ± 1.77) in the girls treated after onset of menstruation and the difference was statistically significant. The percentage decrease in pain score among the girls of premenstrual treatment ranged from 14.28% to 80.0% with median decrease 55.56%, compared to 0.0% to 62.5% with median decrease 10.56% in the group treated at onset of menstruation. The difference was also statistically significant (P <0.001). Conclusion: NSAIDS can be used effectively to prevent and control primary dysmenorrhea associated symtoms if used before the appearance of symptoms, and targeted groups are in great chance to practice an easier life throughout the entiremenstrual cycle.