Premedication and pain relief with Nubain during second trimester therapeutic pregnancy terminations.
OBJECTIVE
To determine the analgesic efficacy of the opioid agonist-antagonist Nubain during midtrimester therapeutic terminations with intra-amniotic PGF2 alpha or i.m. administration of the PGE2 derivative sulprostone.


METHODS
Following osmotic predilatation with laminaria tents patients were given as a premedication 10 mg Valium, 10 mg Nubain and 0.5 mg atropine i.m. prior to prostaglandin treatment, and sequential doses of Nubain during the uterine contractility period. Patients indicated their own perception of uterine pain on a differential graphic rating scale, and the attending physician also evaluated patients' discomfort on a 5-grade scale.


RESULTS
In 55% of the cases patients experienced only 'mild' or 'moderate' pain. The mean induction-to-abortion interval was short (11.6 +/- 1.3 h). The well known gastrointestinal side-effects of the prostaglandins were avoided.


CONCLUSIONS
Nubain proved effective in stabilizing patients' condition during intra-amniotic instillation of prostaglandin, effectively relieved uterine pain during the myometrial contractility period, prevented the occurrence of prostaglandin-related side-effects, and provided simple and good anesthesia during instrumental removal of the already detached but retained placenta.
Kovács
L
L
Department of Obstetrics and Gynaecology, Albert Szent-Györgyi Medical University, Szeged, Hungary.
Herczeg
J
J
Szabó
L
L
D000032:Abortion, Therapeutic; D000328:Adult; D015237:Dinoprost; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D009266:Nalbuphine / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy; D010147:Pain Measurement; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011292:Premedication; D014599:Uterus / Q000187:drug effects
D015237:Dinoprost; D009266:Nalbuphine