Comparison of Effectiveness of Pain Management during Manual Vacuum Aspiration Using Single-Agent Analgesic and Combination: A Randomized Double-Blind Controlled Trial

Of all the methods available for the management of first trimester miscarriages, manual vacuum aspiration is the safest, cheapest and fastest. However, pain caused by manipulation of cervix and uterine suction makes it uncomfortable. We compared the clinical effectiveness and adverse effects of combination of non-selective COX inhibitor (Diclofenac Sodium 50 mg) and opioid (Pentazocine 60 mg) to commonly used opiod only (Pentazocine 60 mg) in daily practice of pain management for the treatment of incomplete abortion with manual vacuum aspiration. This was a randomized double-blind controlled trial conducted in Gynaecological Emergency clinic of Aminu Kano Teaching Hospital Kano, Nigeria. Comparison of the level of pain experienced during the procedure revealed statistically significant difference in the level of pain reported among the groups (P-value 0.03). Comparison of severity of pain perception and patients’ satisfaction was found to be negatively related (P < 0.000001). The present study shows that the use of combined analgesia compared to single agent analgesia during MVA is more, safe, significantly reduced pain and improved patient satisfaction during the procedure.