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Related Experiment Videos

Intra-cervical versus i.v. fentanyl for abortion.

E R Wiebe1, K J Trouton, E Savoy

  • 1Department of Family Practice, University of British Columbia, Canada. ellenwiebe@telus.net

Human Reproduction (Oxford, England)
|April 16, 2005
PubMed
Summary

Intravenous fentanyl provided better pain control during abortions compared to intra-cervical fentanyl. This study found IV fentanyl more effective for managing procedural pain in first-trimester abortions.

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Anxieties and attitudes towards abortion in women presenting for medical and surgical abortions.

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC·2004

Area of Science:

  • Obstetrics and Gynecology
  • Pain Management
  • Pharmacology

Background:

  • First-trimester abortions commonly involve a paracervical block for pain relief, but significant procedural pain persists.
  • Investigating fentanyl's role in paracervical blocks could enhance pain management and reduce side effects.
  • Avoiding intravenous (IV) access is a consideration for women undergoing abortion procedures.

Purpose of the Study:

  • To compare the efficacy of intravenous fentanyl versus intra-cervical fentanyl in managing pain during first-trimester abortions.
  • To assess and compare the side effect profiles of the two fentanyl administration methods.

Main Methods:

  • A randomized, double-blind, placebo-controlled trial was conducted in an urban abortion clinic.
  • Participants received a paracervical block with either 100 mcg of fentanyl administered intravenously (IV) or intra-cervically (IC).
  • Pain scores and reported side effects were the primary outcome measures.

Main Results:

  • A total of 202 women participated (104 IV fentanyl, 98 IC fentanyl), with similar demographic and obstetric profiles.
  • Intravenous fentanyl resulted in significantly lower pain scores during dilation (4.7 vs 5.7, P=0.01) and suctioning (3.8 vs 5.6, P<0.001) compared to intra-cervical fentanyl.
  • While side effects were comparable, more women in the IV group received anti-emetics, and more in the IC group reported dissatisfaction with pain control.

Conclusions:

  • Intravenous fentanyl administration is more effective than intra-cervical administration for pain control during first-trimester abortions.
  • The findings suggest IV fentanyl offers superior pain relief in this context, despite comparable side effect profiles.

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