A RANDOMIZED CONTROL TRIAL COMPARING PARACERVICAL BLOCK WITH PENTAZOCINE FOR PAIN RELIEF DURING MANUAL VACUUM ASPIRATION

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A RANDOMIZED CONTROL TRIAL COMPARING PARACERVICAL BLOCK WITH PENTAZOCINE FOR PAIN RELIEF DURING MANUAL VACUUM ASPIRATION

Abstract

BACKGROUND: The management of abortion using manual vacuum aspiration causes pain that could be unbearable for patients. A good pain management toprevent this as well as improve patients’ satisfaction is essential. Comparing parenteralpentazocine with paracervical block in a randomized control trial will give an insight as to the more effective option with fewer side effects.

OBJECTIVE: To compare the effectiveness of pain management during manual vacuum aspiration and the side effect profile between intravenous pentazocine and 1% lignocaine during paracervical block in a randomized control trial.
DESIGN: Randomized controlled trial

METHODOLOGY: In this study, 100 patients attending the gynaecological emergency unit, diagnosed with incomplete abortion were randomized into two groups(50 patients in each group) to ascertain an effective method of pain relief with better side effect profile during manual vacuum aspiration. Following manual vacuum aspiration, pain scores were obtained with a visual analogue scale while the side effect profile was obtained using a questionnaire. Statistical analysis was done on the data obtained using statistical package for social sciences version 21 for windows (IBM Corp, Armonk, NY, USA).

RESULTS: Majority (72%) of the patients in the paracervical block arm had mild pain and the mean pain score in this group was 2.91(SD+1.84). This value was less than the range obtained for majority (56%) of the patients that had pentazocine with a mean pain score of 4.44(SD+1.85) placing them in the moderate pain range and this was statistically significant (p value=0.002).When the mean pain scores of the two groups was compared using the independent t-test, there was a statistically significant difference (P=0.0005) with those in the paracervical block arm experiencing less pain. Paracervical block had less side effect compared to pentazocine and it was statistically significant for headache (p value=0.0005), dizziness (p value=0.0005), nausea (p=0.003), vomiting (p=0.001), weakness (p=0.0005), blurred vision (p=0.01) and double vision (p=0.039). There was no statistical significance when tremor and confusion was compared among the two groups.

CONCLUSION:Paracervical block using 1% lidocaine when compared with intravenous pentazocine is a better form of pain relief during manual vacuum aspiration as it is more effective with fewer side effects and this was shown to be statistically significant from the study. Therefore, it should be used as the preferred form of analgesia for all patients undergoing manual vacuum aspiration with incomplete abortion.

 

A RANDOMIZED CONTROL TRIAL COMPARING PARACERVICAL BLOCK WITH PENTAZOCINE FOR PAIN RELIEF DURING MANUAL VACUUM ASPIRATION

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