A randomized trial of pain relief in termination of pregnancy in South Africa.
The aim of this prospective trial was to evaluate and compare paracervical block with diclofenac for pain relief during manual vacuum aspiration (MVA) for surgical termination of pregnancy. Participants were randomized into three groups, viz. group (i) diclofenac 75 mg intramuscularly (i.m.) 30 min before the procedure; (ii) diclofenac 75 mg i.m. 30 min before the procedure, together with local infiltration of the cervix with lignocaine 1% (10 mL); (iii) diclofenac 75 mg i.m. 30 min before the procedure together with local infiltration of the cervix with lignocaine 1% (10 mL) and paracervical block with lignocaine 1% (5 mL). There was a significant difference in pain scores during the procedure between groups (i) and (ii) (P < 0.001), and between groups (i) and (iii) (P < 0.001) in pain scores during the procedure. There was no difference in pain score between groups (ii) and (iii) (P = 0.144). Post procedure analysis of pain score also showed significant difference between group (i) on one hand, and groups (ii) and (iii) (P < 0.001), but no significant difference between groups (ii) and (iii)(P = 0.029). The local anaesthetic infiltration of the cervix in combination with diclofenac or together with diclofenac and paracervical block provides better pain relief during and after the MVA.
Owolabi
O T
OT
Department of Obstetrics and Gynaecology, Nelson R Mandela School of Medicine, Durban, South Africa.
Moodley
J
J
D000028:Abortion, Induced / Q000009:adverse effects* / Q000379:methods; D000293:Adolescent; D000328:Adult; D000773:Anesthesia, Obstetrical; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D004008:Diclofenac / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008012:Lidocaine; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D011446:Prospective Studies; D013019:South Africa; D014619:Vacuum Curettage / Q000009:adverse effects
D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D008012:Lidocaine