Paracervical block and elective abortion: the effect on pain of waiting between injection and procedure.

Abstract

Our purpose was to assess the effect on pain and patient satisfaction of waiting between paracervical block and dilation during first-trimester abortions. One hundred ninety-nine women seeking pregnancy termination were randomly assigned to a no-wait group (group 1) and a 3- to 5-minute wait between injection and dilation group (group 2). Subjects rated their pain on a visual analog scale at four times: prior to procedure, with dilation, with aspiration, and 30 to 45 minutes after procedure. No significant differences were observed in pain or satisfaction ratings reported by group 1 (n = 93) and group 2 (n = 101). A significant decrease in pain with dilation (1.21 cm decrease, P =.009) and aspiration (1.15 cm decrease, P =.0015) was observed among patients who received fentanyl. Delay between paracervical injection and dilation during first-trimester abortion does not have an impact on patient pain or satisfaction. Fentanyl decreased pain scores by 20% to 25% during the procedure.