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Hum. Reprod. Advance Access published online on April 14, 2005
Human Reproduction, doi:10.1093/humrep/deh892
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received December 8, 2004
Revised February 22, 2005
Accepted March 3, 2005

Article

Intra-cervical versus i.v. fentanyl for abortion

E.R. Wiebe 1*, K.J. Trouton 1, and E. Savoy 1

1 Department of Family Practice, University of British Columbia, Canada

* To whom correspondence should be addressed.
E.R. Wiebe, E-mail: ellenwiebe{at}telus.net


  Abstract

BACKGROUND: The majority of abortions are performed using a para-cervical block (without general anaesthesia) and involve a significant amount of pain. If fentanyl was given with the lidocaine in the para-cervical block, it potentially could improve pain control while decreasing side effects and avoiding i.v. access for women having abortions. METHODS: This was a randomized double-blind placebo-controlled trial of two treatment arms: (i) para-cervical block with 100 µg of fentanyl i.v; or (ii) para-cervical block with 100 µg of fentanyl intra-cervically (i.c.) for first trimester abortion. The setting was a free-standing urban abortion clinic. The outcome measures were pain scores and side effects. RESULTS: A total of 104 women received the fentanyl i.v. and 98 received the fentanyl i.c. The two groups were similar with respect to age, gestational age, obstetric history, anxiety and depression. Pain scores (0-10) were 4.7 and 5.7 for dilation (P=0.01) and 3.8 and 5.6 for suctioning (P<0.001) in the i.v. and i.c. groups, respectively. Side effects were similar, but more women in the i.v. group received anti-emetics. More women in the i.c. group were dissatisfied with the pain control. CONCLUSION: I.v. fentanyl is more effective than i.c. fentanyl for pain control in abortion.

Keywords: abortion; fentanyl; pain; paracervical block; randomized controlled trial.
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