Effect of paracetamol, dexketoprofen trometamol, lidocaine spray, and paracervical block application for pain relief during suction termination of first-trimester pregnancy

Gökhan Açmaz, Hüseyin Aksoy, Nil Özoğlu, Ülkü Aksoy, Evrim Albayrak, Gökhan Açmaz, Hüseyin Aksoy, Nil Özoğlu, Ülkü Aksoy, Evrim Albayrak

Abstract

The aim of the study was to investigate the analgesic efficacy of preoperative oral dexketoprofen trometamol, intravenous paracetamol, lidocaine spray, and paracervical block with ultracaine on curettage procedure. A total of 111 subjects with the request of pregnancy termination between 5 and 7 weeks of gestation were included in the study. The first group (control group) consisted of 20 participants without medication. The second group consisted of 25 participants receiving 2 puffs of lidocaine sprays on cervical mucosa. The third group consisted of 20 participants receiving oral 25 mg dexketoprofen trometamol. The fourth group consisted of 23 participants receiving 1000 mg intravenous paracetamol and the fifth group consisted of 23 participants receiving paracervical block with ultracaine. Paracervical block reduced pain score significantly in both intraoperative and postoperative periods. All analgesic procedures were significantly effective for reducing pain in postoperative period. Paracervical block may be the best method for reducing pain scores in intraoperative and postoperative periods during curettage procedure. All analgesic procedures such as lidocaine, paracetamol, ultracaine, and paracervical block with ultracaine can be used for reducing pain score in postoperative period. This trial is registered with NCT01947205.

References

    1. Trolice MP, Fishburne C, Jr., McGrady S. Anesthetic efficacy of intrauterine lidocaine for endometrial biopsy: a randomized double-masked trial. Obstetrics and Gynecology. 2000;95(3):345–347.
    1. Lichtenberg ES, Paul M, Jones H. First trimester surgical abortion practices: a survey of National Abortion Federation members. Contraception. 2001;64(6):345–352.
    1. Blough RE, Wu M. Acetaminophen: beyond pain and Fever-relieving. Frontiers in Pharmocology. 2011;2(72):1–6.
    1. Yalcin N, Uzun ST, Reisli R, Borazan H, Otelcioglu S. A comparison of ketamine and paracetamol for preventing remifentanil induced hyperalgesia in patients undergoing total abdominal hysterectomy. International Journal of Medical Science. 2012;9(5):327–333.
    1. Harris SI, Stoltz RR, LeComte D, Hubbard RC. Parecoxib sodium demonstrates gastrointestinal safety comparable to placebo in healthy subjects. Journal of Clinical Gastroenterology. 2004;38(7):575–580.
    1. Api O, Ergen B, Api M, Ugurel V, Emeksiz MB, Unal O. Comparison of oral nonsteroidal analgesic and intrauterine local anesthetic for pain relief in uterine fractional curettage: a randomized, double-blind, placebo-controlled trial. American Journal of Obstetrics and Gynecology. 2010;203(1, article 28):e1–e7.
    1. Mankowski JL, Kingston J, Moran T, Nager CW, Lukacz ES. Paracervical compared with intracervical lidocaine for suction curettage: a randomized controlled trial. Obstetrics and Gynecology. 2009;113(5):1052–1057.
    1. Wallace MS. Calcium and sodium channel antagonists for the treatment of pain. The Clinical Journal of Pain. 2000;16(2):S80–S85.
    1. Sinclair R, Westlander G, Cassuto J, Hedner T. Postoperative pain relief by topical lidocaine in the surgical wound of hysterectomized patients. Acta Anaesthesiologica Scandinavica. 1996;40(5):589–594.
    1. Api O, Unal O, Ugurel V, Emeksiz MB, Turan C. Analgesic efficacy of intravenous paracetamol for outpatient fractional curettage: a randomised, controlled trial. International Journal of Clinical Practice. 2009;63(1):105–111.
    1. Blumenthal PD, Remsburg RE. A time and cost analysis of the management of incomplete abortion with manual vacuum aspiration. International Journal of Gynecology and Obstetrics. 1994;45(3):261–267.
    1. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC III, Wenstrom KD, editors. Williams Obstetrics. 22nd edition. New York, NY, USA: McGraw-Hill; 2005. Obstetrical anesthesia; pp. 479–480.
    1. Flouvat B, Leneveu A, Fitoussi S, Delhotal-Landes B, Gendron A. Bioequivalence study comparing a new paracetamol solution for injection and propacetamol after single intravenous infusion in healthy subjects. International Journal of Clinical Pharmacology and Therapeutics. 2004;42(1):50–57.
    1. Arici S, Gurbet A, Türker G, Yavaşcaoğlu B, Şahin Ş. Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy. Ağrı. 2009;21(2):54–61.
    1. Li HWR, Wong CYG, Lo SST, Fan SYS. Effect of local lignocaine gel application for pain relief during suction termination of first-trimester pregnancy: a randomized controlled trial. Human Reproduction. 2006;21(6):1461–1466.
    1. Xu DZ, Li MF, Wu XM, et al. Randomized trial of the effect of drugs on cervical dilatation for termination of first trimester pregnancy. Contraception. 1990;41(6):663–670.
    1. Owolabi OT, Moodley J. A randomized trial of pain relief in termination of pregnancy in South Africa. Tropical Doctor. 2005;35(3):136–139.
    1. Grimes DA, Cates W., Jr. Deaths from paracervical anesthesia used for first trimester abortion, 1972–1975. The New England Journal of Medicine. 1976;295(25):1397–1399.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться