title: Analgesia/pain management in first trimester surgical abortion.
abstract: Management of pain during abortion is a critical aspect of patient care. Although it is not always possible to offer a range of pain control options in every setting, individualizing pain medications as much as possible for patients' preferences is likely to improve satisfaction with the abortion experience. Evidence suggests that higher volume (at least 200 mg lidocaine) and deeper injections are beneficial for cervical block. Adding intravenous sedation with a moderate dose of fentanyl and midazolam reduces the pain scores. Oral benzodiazepines may improve satisfaction and anxiety. Deep sedation and general anesthesia are important options for women with significant medical conditions or complicated procedures.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA. meckstrothk@obgyn.ucsf.edu
authors.forename: Karen R
authors.initials: KR
authors.lastname: Meckstroth
authors.forename: Kavita
authors.initials: K
authors.lastname: Mishra
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000494:pharmacology; D000028:Abortion, Induced; D000772:Anesthesia, Local; D000773:Anesthesia, Obstetrical; D000779:Anesthetics, Local / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D001569:Benzodiazepines / Q000008:administration & dosage; D020070:Cervical Ripening / Q000187:drug effects; D016292:Procedural Sedation; D003376:Counseling; D005260:Female; D005865:Gestational Age; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D016595:Misoprostol / Q000494:pharmacology; D010147:Pain Measurement; D011247:Pregnancy; D011261:Pregnancy Trimester, First
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D016595:Misoprostol; D001569:Benzodiazepines; D008012:Lidocaine