Pain control in abortion.
OBJECTIVE
To reduce the pain experienced during abortion.


METHODS
A four-phase study was conducted at a free-standing abortion clinic. Phase 1: a double-blind, randomized, placebo-controlled trial of 600 mg ibuprofen given preoperatively was carried out in 193 women. Pain during the procedure and 30 min postoperatively was compared. Phase 2: a double-blind, randomized trial compared 1% lidocaine, buffered 1% lidocaine and 0.25% bupivacaine in terms of the pain of the injection and the pain of the procedure in 200 women. Phase 3: waiting times of 0, 3 and 10-20 min between the end of the injection and the beginning of the procedure were compared in terms of pain during the procedure in 139 women. Phase 4: local anesthetic was injected into one side of the cervix slowly and one side quickly and the pain of the injections was compared in 87 women.


RESULTS
Phase 1: ibuprofen reduced pain scores more than placebo with the improvement being greatest for the postoperative period. Phase 2: buffered lidocaine was significantly less painful to inject than plain lidocaine or bupivacaine. Phase 3: waiting between the injection and the procedure did not improve pain control. Phase 4: slower injections were found to be less painful than fast injections.


CONCLUSIONS
Several methods were found to improve pain control during abortions.
Wiebe
E R
ER
Department of Family Practice, University of British Columbia, Vancouver, Canada.
Rawling
M
M
D000032:Abortion, Therapeutic; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D008012:Lidocaine / Q000008:administration & dosage*; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011247:Pregnancy; D011446:Prospective Studies
D000779:Anesthetics, Local; D008012:Lidocaine; D007052:Ibuprofen; D002045:Bupivacaine