Journal
CONTRACEPTION
Volume 97, Issue 6, Pages 471-477Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.contraception.2018.01.014
Keywords
Surgical abortion; Pain; Paracervical block; First-trimester induced abortion; Topical anesthesia; Nonsteroidal anti-inflammatory drugs
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Satisfactory pain control for women undergoing surgical abortion is important for patient comfort and satisfaction. Clinicians ought to be aware of the safety and efficacy of different pain control regimens. This document will focus on nonpharmacologic modalities to reduce pain and pharmacologic interventions up to the level of minimal sedation. For surgical abortion without intravenous medications, a multimodal approach to pain control may combine a dedicated emotional-support person, visual or auditory distraction, administration of local anesthesia to the cervix with buffered lidocaine and a preoperative nonsteroidal anti-inflammatory drug. Oral opioids do not decrease procedural pain. Oral anxiolytics decrease anxiety but not the experience of pain. Further research is needed on alternative options to control pain short of moderate or deep sedation. (C) 2018 Elsevier Inc. All rights reserved.
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