A Comparative Study on the Effectiveness of Paracervical Block and Diclofenac Versus Paracervical Block and Pentazocine for Analgesia During Manual Vacuum Aspiration

Authors

  • Malgwi J. Usman Department of Obstetrics and Gynaecology, Maitama District Hospital Abuja, Nigeria
  • C. N. Nwachukwu Department of Obstetrics and Gynaecology, Maitama District Hospital Abuja, Nigeria
  • F. E. Alu Department of Obstetrics and Gynaecology, Maitama District Hospital Abuja, Nigeria
  • Ebiogbo S. Ozori Department of Obstetrics and Gynaecology, Federal Medical Centre Yenagoa, Bayelsa, Nigeria
  • Abuchi L. Okpara Department of Obstetrics and Gynaecology, Federal Medical Centre Yenagoa, Bayelsa, Nigeria
  • Yelwa Usman Department of Obstetrics and Gynaecology, Maitama District Hospital Abuja, Nigeria
  • Ochuko M. Alabintei Department of Obstetrics and Gynaecology, Federal Medical Centre Yenagoa, Bayelsa, Nigeria
  • Peter I. Ogidigba Department of Obstetrics and Gynaecology, Federal Medical Centre Yenagoa, Bayelsa, Nigeria

DOI:

https://doi.org/10.14738/jbemi.94.12761

Abstract

Management of incomplete abortion with the use of manual vacuum aspiration is associated with pain. A good pain relief option is necessary during the procedure to improve the outcome and increase patients’ satisfaction. The study was aimed atdetermining and comparing the effectiveness of combining paracervical block with pentazocine and paracervical block with diclofenac as pain relief during manual vacuum aspiration for first-trimester incomplete abortion. This study involved 100 eligible women with the diagnosis of first-trimester incomplete abortion. Half of the participants were given paracervical block and intramuscular pentazocine 60 mg stat while the other half were given paracervical block and intramuscular diclofenac 75 mg stat before the manual vacuum aspiration procedure. The intensity of pain during the procedure was assessed using the Visual Analogue Scale (VAS). The level of significance was set at p value<0.05. The mean pain intensity was significantly higher in the diclofenac group than in the pentazocine group. From the study it was concluded that intramuscular pentazocine used as an adjunct to paracervical block during manual vacuum aspiration when compared to intramuscular diclofenac as an adjunct to paracervical block was found to be a more effective method of pain relief. The patient’s level of satisfaction was same in both study arms. However, participants in the pentazocine arm had more side effects.

References

Dastgiri S, Yoosefian M, Garjani M, Kalankesh L. Induced Abortion: a Systematic Review and Meta-analysis. Mater Sociomed. 2017;29(1):58–67.

Gebremedhin M, Semahegn A, Usmael T, Tesfaye G. Unsafe abortion and associated factors among reproductive aged women in Sub- Saharan Africa : a protocol for systematic review and meta-analysis. Syst Rev. 2018;7(130):1–5.

World Health Organisation. Abortion [Internet]. WHO.2021 [cited 2022 Feb 11]. p. 1–5. Available from: https://www.who.int/news-room/fact-sheets/detail/abortion.

Bankole A, Adewole IF, Hussain R, Awolude O, Singh S, Akinyemi JO. The Incidence of Abortion in Nigeria. Int Perspect Sex Reprod Heal. 2015;41(4):170–81.

Natalia A, Galadanci H, Ibrahim S, Mohammad Z. Comparison of Effectiveness of Pain Management during Manual Vacuum Aspiration Using Single-Agent Analgesic and Combination: A Randomized Double-Blind Controlled Trial. Open J Obstet Gynecol. 2015;05(05):244–50.

Patel AJ, Thakkar DA. Para Cervical Block For Cervical Dilatation And Uterine Evacuation By MVA Method: A Safe And Effective Alternative At Tertiary Care, Teaching Hospital. IOSR J Dent Med Sci. 2018;17(5):16–9.

Jesmin N. Efficacy and safety of paracervical block in manual vacuum aspiration (MVA)-in a low resource setting. Bangladesh J Obs Gynaecol. 2017;31(2):70–4.

Praditpan P, Davis AR. Manual vacuum aspiration: A safe and effective treatment for early miscarriage. OBG Manag. 2015;27(10):38–43.

European Society of Human Reproduction and Embryology Capri Workshop Group. Induced abortion. Hum Reprod. 2017;32(6):1160–9.

Allen RH, Singh R. Society of Family Planning clinical guidelines pain control in surgical abortion part 1 — local anaesthesia and minimal sedation. Contraception. 2018;97(6):471–77.

International Projects Assistance Services. Clinical updates in reproductive health [Internet]. Clinical Updates in Reproductive Health. Chapel Hill;.2019. Available from: https://www.ipas.org/resource/clinical-updates-in-reproductive-health.

Mahapatra SJ, Jain S, Bopanna S, Gupta S, Singh P, Trikha A, et al. Pentazocine, a Kappa-Opioid Agonist, Is Better Than Diclofenac for Analgesia in Acute Pancreatitis: A Randomized Controlled Trial. Am J Gastroenterol. 2019;114(5):813–21.

Nwagwu CC, Ebirim LN, Ojule JD, Ezike HA. Comparative Study of Parenteral Diclofenac and Pentazocine for Post-Caesarean Analgesia after Subarachnoid Block. African J Anaesth Intensive Care. 2016;16(2):17–24.

Egede JO, Ajah LO, Umeora OU, Ozumba BC, Onoh RC, Obuna JA, et al. Pentazocine alone versus Pentazocine plus Diclofenac for pain relief in the first 24 hours after Caesarean Section: A randomized controlled study. J Clin Diag Res.2017;11(4):QC01–5.

Downloads

Published

2022-08-20

How to Cite

Usman, M. J., Nwachukwu, C. N., Alu, F. E., Ozori, E. S., Okpara, A. L., Usman, Y., Alabintei, O. M., & Ogidigba, P. I. (2022). A Comparative Study on the Effectiveness of Paracervical Block and Diclofenac Versus Paracervical Block and Pentazocine for Analgesia During Manual Vacuum Aspiration. British Journal of Healthcare and Medical Research, 9(4), 175–188. https://doi.org/10.14738/jbemi.94.12761