Nitrous Oxide versus Oral Sedation in Pain Management of First-Trimester Surgical Abortion

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SCIENCE
Nitrous Oxide versus Oral Sedation in Pain Management of First-Trimester Surgical Abortion
Key Take-Away: 

Nitrous oxide (N2O) can be used as a promising alternative to oral sedatives in women undergoing the first-trimester surgical abortion.

Pain management becomes a noteworthy matter for women undergoing the first-trimester surgical abortion.

ABSTRACT: 
Background: 

Pain management becomes a noteworthy matter for women undergoing the first-trimester surgical abortion.

The present study compared nitrous oxide with oxygen (N2O/O2) to oral hydrocodone/acetaminophen and lorazepam for analgesia during the first-trimester surgical abortion.

Methods: 

This double-blind, randomized trial assigned women undergoing the first-trimester surgical abortion at<11 weeks' gestation to inhaled N2O/O2 vs. oral sedation for pain management.

The N2O/O2 group received up to 70:30 ratio during the procedure and placebo pills pre-procedure; the oral group received inhaled oxygen during the procedure and oral hydrocodone/acetaminophen 5 mg/325 mg and lorazepam 1 mg pre-procedure. The primary endpoint was the maximum procedural pain, assessed on a 100-mm visual analog scale (VAS; anchors 0=no pain and 100=worst pain) at 2 min post-procedure. A difference of 13 mm on the VAS was considered clinically significant. Satisfaction with pain management was measured on a 100-mm VAS (anchors 0=very unsatisfied, 100=very satisfied).

Results: 

A total of 140 women were randomized, 70 in each group. The mean age of participants was 26±6.6 years; mean gestational age was 7.3±1.5 weeks.

Mean maximum procedure pain scores were 52.5±26.7 and 60.8±24.4 for N2O/O2 and oral groups, respectively (p=0.09). Satisfaction with pain management was 69.3±28.4 and 61.5±30.4 for N2O/O2and oral groups. respectively (p=.15).

Conclusion: 

No difference was found in mean procedural pain scores between two groups. Satisfaction with both the treatment options was high. Women undergoing early surgical abortion experienced no differences in pain and satisfaction between those who used inhaled nitrous oxide and oral sedation. Nitrous oxide, with side effects limited to the duration of inhalation and no need for a ride home, is a viable alternative to oral sedation for first-trimester abortion pain management.

 

Source:

Contraception

Link to the source:

http://www.contraceptionjournal.org/article/S0010-7824(17)30165-8/fulltext?rss=yes

The original title of the article:

Nitrous oxide versus oral sedation for pain management of first-trimester surgical abortion — a randomized study

Authors:

Rameet H. Singh et al

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