Analgesic efficacy and safety of paracervical block versus conscious sedation in the surgical evacuation of the uterus following first-trimester incomplete miscarriages: A randomised controlled trial

Author:

Nweke Nnenna A1,Anikwe Chidebe Christian2ORCID,Ewah Richard L3,Umeononihu Osita S2,Eze Justus N1

Affiliation:

1. Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Nigeria

2. Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

3. Department of Anaesthesia, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Nigeria

Abstract

Objective: To compare the analgesic efficacy and safety of paracervical block and conscious sedation in the surgical evacuation of the uterus following a first-trimester miscarriage. Methods: This is an open-label, randomised control trial comparing pain relief by paracervical block versus conscious sedation during manual vacuum aspiration of first-trimester incomplete miscarriages. One-hundred and sixty-two women were equally randomised into two groups. Group A (paracervical group) received a paracervical block of 4 ml of lidocaine each at the 4 and 8 o’clock positions. Group B (conscious sedation group) received intravenous 30 mg pentazocine and 10 mg diazepam. Data obtained were presented using a frequency table, student t-test, chi-square and Mann–Whitney test and bar chart. A P-value of ⩽0.05 was taken to be statistically significant. Results: The mean pain score was lower in the paracervical block group compared to the conscious sedation group (P < 0.05); however, there was no significant difference in women’s satisfaction between the groups (P ⩾ 0.05). Conscious sedation had more negative side effects compared to paracervical block which was significant (P < 0.05). Conclusion: Paracervical block has better pain control compared with conscious sedation and has a good side effect profile. Trial registration: Pan African Clinical Trial Registry (registered trial no. PACTR202108841661192). Synopsis Paracervical block for manual vacuum aspiration (MVA) during first-trimester miscarriage is associated with less pain among women compared with conscious sedation.

Publisher

SAGE Publications

Subject

General Medicine

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Women's Perceptions of Medical Treatment Versus Surgical Management of First-trimester Miscarriage;Clinical Journal of Obstetrics and Gynecology;2023-11-27

2. A Multimodal Approach toward Pain Relief during Dilatation and Curettage: A Randomized Clinical Study;Journal of South Asian Federation of Obstetrics and Gynaecology;2023-07-31

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