Pain control in first trimester surgical abortion

Comparative study of patients undergoing check curettage for first trimester incomplete and inevitable abortion under paracervical block versus no anesthesia

“…1 In the study by Calvache et al, pain during curettage was not studied, but the post operative pain was significantly lower in the lignocaine group as compared to saline. 8 In the study by Tangsiriwatthana the pain during curettage was significantly lower in the lignocaine group as compared to saline.…”

“…1,8,9 Each study had investigated the effect of a particular type of anesthesia and compared it to either another type or another dose of anesthesia. In spite of the numerous studies performed, consensus is still lacking as to the preferred and safest mode of anesthesia for patients with an incomplete abortion.…”

“…Pain perception during the procedure varies among different women depending on the interaction of psychosocial and physical factors. 1 The Frankenhäuser plexus innervates the cervix and the lower part of the uterine cavity and gets stimulated during cervical dilatation thereby causing pain. [1][2][3] Therefore it can be hypothesized that in cases of incomplete and inevitable abortions where the cervical os is already dilated, the need for anesthesia is circumvented, thereby reducing cost of treatment.…”

Hypnoanalgesia for Dilatation and Curettage Pain Control

“…Renner et al used hypnoanalgesia for controlling pain in patients with abortion showing that analgesic drugs could significantly reduce patients’ pain ( 15 ). Dufresne et al also applied hypnoanalgesia successfully to 290 women with abortion ( 16 ).…”

Randomized, controlled, double‐blind trial of topical lidocaine gel and intrauterine lidocaine infusion for pain relief during saline contrast sonohysterography

“…Local anesthetic (gel, spray and intrauterine infusion) and paracervical blocks have been investigated for reducing pain in minor gynecological procedures. Studies found that paracervical block significantly reduced pain during hysterosalpingography, hysteroscopy and surgical termination of pregnancy, but its use is limited by its potential toxicity including the risk of bradycardia and hypotension due to inadvertent intravascular injection. Intrauterine lidocaine infusion was shown to reduce pain during SCSH, hysteroscopy and endometrial sampling, but not hysterosalpingography.…”