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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
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.
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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