TITLE:
Analgesic Efficacy of Paracervical Block for Manual Vacuum Aspiration of Incomplete Abortions: A Randomized Controlled Trial
AUTHORS:
Ekundayo O. Ayegbusi, Akintunde O. Fehintola, Akinyosoye D. Ajiboye, Ayodele Idowu, Tope O. Okunola, Michael S. Archibong, Olajide E. Babalola, Olusegun O. Badejoko, Morebise O. Loto
KEYWORDS:
Postabortion Care, Pain, Placebo, Paracervical Block
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.8,
August
9,
2021
ABSTRACT: Introduction: Pain control during Manual Vacuum Aspiration is one of the most
important aspects of postabortion care.
This study assessed the analgesic efficacy, requirement for additional
analgesia, and overall satisfaction using Paracervical blocks of 1% lignocaine
compare with normal saline as placebo among women undergoing manual vacuum aspiration for incomplete abortion in
OAUTHC, Ile-Ife. Methods: This was a double
blind randomized controlled trial that occurred between January 2019 and
February 2020. We randomized one hundred and twenty eligible women equally into
2 groups. Group A received paracervical block using 1% lignocaine while those
in group B received paracervical block using normal saline as placebo. We obtained ethical clearance from the Ethics and Research Committee of
the hospital. Preoperatively, we obtained relevant data and evaluated the
degree of anxiety and pain on a visual analog scale (VAS). Intraoperative pain
was evaluated from 2 viewpoints: that of the external observer on a 0 - 4 scale
and that of the patient scale of 0 - 10 in the immediate postoperative period,
followed by overall satisfaction at the point of discharge. We analyzed the
data using SPSS version 20. Paired T test,
independent T test Chi square, and Fishers’ exact tests were
applied for continuous and categorical variables as appropriate. P value as statistically significant. Results: The Intra-operative and Postoperative VAS was significantly higher in the placebo group compared to the analgesia group (t = -3.39, CI -4.11 - -2.69. P AS of those in the placebo group was significantly higher than that of
the study group with higher overall satisfaction rate in the study group (t =
7.18. CI 2.62 - 6.71. P Conclusions: Paracervical block
with 1% lignocaine is more effective in reducing pain during manual vacuum
aspiration compared to placebo. It has added advantage of a higher overall
satisfaction rate and reduced need for additional analgesia.