Objective: The purpose of this study was to determine the analgesic effect of a flurbiprofen ester injection via continuous intravenous drip during transvaginal 4-dimensional hysterosalpingography (TVS 4D-HyCoSy). Methods: Two hundred thirty patients who underwent TVS 4D-HyCoSy for infertility from May 2018 to August 2021 at our hospital were selected. The participants were grouped based on tubal patency, flurbiprofen ester use, and uterine cannula diameter, as follows: bilateral tubal patency group; non-bilateral tubal patency group; atropine group; atropine + flurbiprofen ester group; coarse tube group; and fine tube group. The analgesic effect during TVS 4D-HyCoSy and pain relief were compared between groups using visual analog scoring (NRS). Additionally, the incidence of adverse effects was recorded and factors related to the influence of pain were analyzed. Results: 1. Tubal patency reduced pain during ultrasound tubal examination, flurbiprofenate provided significant analgesia after ultrasound tubalography and reduced adverse effects (P < 0.001). 2. The tube diameter thickness had no effect on tubal ultrasonography procedure-related pain. 3. Multivariable analysis of pain relief during imaging suggested that the use of flurbiprofen for bilateral tubal patency had a significant positive effect on pain relief within 30 min after the examination with an AUC of 0.732 (95% CI: 0.665–0.798). Conclusion: A flurbiprofen ester continuous intravenous drip had a good analgesic effect in patients with TVS 4D-HyCoSy. Specifically, the pain relief effect after examination was significant and reduced the incidence of adverse reactions during the contrast examination. Flurbiprofen ester can be administered independently and is worthy of clinical promotion and application.
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