title: Nonpharmaceutical Pain Control Adjuncts During First-Trimester Aspiration Abortion: A Review.
abstract: BACKGROUND
  First-trimester aspiration abortion is associated with moderate to severe pain. The effectiveness of adjunctive therapies for pain control is not well understood. This critical review summarizes the existing literature regarding nonpharmacologic interventions to reduce pain during first-trimester office-based abortion.
  
  
  METHODS
  PubMed and Google Scholar were searched using the following search terms in various combinations: "abortion," "pain," "nonpharmaceutical," "nonpharmacologic," "anxiety," "fear," "pain management," "pain reduction," "anxiety reduction," "complementary and alternative medicine," and "integrative medicine." Seven articles meeting inclusion criteria were entered into a matrix for comparison. Findings from each study are summarized describing design, results, and themes. These results are summarized to provide evidence-based clinical guidelines and identify areas for further research.
  
  
  RESULTS
  None of the nonpharmacologic interventions studied were significantly associated with a reduction in pain or anxiety scores. However, women in many studies strongly endorsed future use of these techniques.
  
  
  CONCLUSIONS
  The data included in this critical review did not demonstrate a relationship between the nonpharmacologic interventions and pain or anxiety scores, yet participants endorsed these as positive and helpful. Women found value in these supportive interventions, and ongoing investigation into these techniques is warranted.
authors.forename: Mary
authors.initials: M
authors.lastname: Tschann
authors.forename: Jennifer
authors.initials: J
authors.lastname: Salcedo
authors.forename: Bliss
authors.initials: B
authors.lastname: Kaneshiro
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects* / Q000379:methods; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D000529:Complementary Therapies; D005260:Female; D006801:Humans; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D018802:Patient-Centered Care / Q000379:methods; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011369:Professional-Patient Relations
keywords: critical review; first-trimester abortion; integrative; nonpharmaceutical; nonpharmacologic; pain management