Intravenous Ketamine for Pain Control in First-Trimester Surgical Abortion: Interim Analysis of a Randomized...

Area of Science:

• Obstetrics and Gynecology
• Anesthesiology
• Pain Management

Background:

• Surgical abortion is a common procedure, typically performed in the first trimester.
• Current standard pain management involves intravenous fentanyl and midazolam, necessitating continuous cardio-respiratory monitoring.
• The opioid crisis necessitates investigation into non-opiate analgesia alternatives.

Purpose of the Study:

• To compare the efficacy of intravenous ketamine, oral morphine, and intravenous fentanyl for pain control during first-trimester surgical abortion.
• To evaluate patient satisfaction with different anesthetic methods.
• To identify potential non-opiate analgesia for surgical abortion.

Main Methods:

• A double-blind, single-center superiority randomized controlled trial was conducted.
• Participants (n=43) were adults with pregnancies <12 weeks gestation.
• Pain was assessed using the Visual Analogue Scale and Wong-Baker Faces Pain Rating Scale.

Main Results:

• Ketamine demonstrated significantly better intra-operative pain control compared to both morphine and fentanyl (P < 0.001).
• Patients receiving ketamine reported higher satisfaction with the anesthetic method than those receiving morphine (P = 0.017).
• No serious adverse events were reported in any treatment group.

Conclusions:

• Ketamine is a promising non-opiate analgesic for first-trimester surgical abortion.
• The findings support the continuation of the randomized controlled trial.
• Ketamine may be a suitable alternative for pain management in settings lacking continuous cardio-respiratory monitoring.