Analgesic Efficacy of Paracervical Block for Manual Vacuum Aspiration of Incomplete Abortions: A Randomized Controlled Trial

Introduction: Pain control during Manual Vacuum Aspiration is one of the most important aspects of postabortion care. This study assessed the analgesic efficacy, requirement for additional analgesia, and overall satisfaction using Paracervical blocks of 1% lignocaine compare with normal saline as placebo among women undergoing manual vacuum aspiration for incomplete abortion in OAUTHC, Ile-Ife. Methods: This was a double blind randomized controlled trial that occurred between January 2019 and February 2020. We randomized one hundred and twenty eligible women equally into 2 groups. Group A received paracervical block using 1% lignocaine while those in group B received paracervical block using normal saline as placebo. We obtained ethical clearance from the Ethics and Research Committee of the hospital. Preoperatively, we obtained relevant data and evaluated the degree of anxiety and pain on a visual analog scale (VAS). Intraoperative pain was evaluated from 2 viewpoints: that of the external observer on a 0 - 4 scale and that of the patient scale of 0 - 10 in the immediate postoperative period, followed by overall satisfaction at the point of discharge. We analyzed the data using SPSS version 20. Paired T test, independent T test Chi square, and Fishers’ exact tests were applied for continuous and categorical variables as appropriate. P value < 0.05 was considered as statistically significant. Results: The Intra-operative and Postoperative VAS was significantly higher in the placebo group compared to the analgesia group (t = -3.39, CI -4.11 - -2.69. P < 0.05 intra-operative, t = 7.18, CI 2.62 - 4.61. P < 0.05 post-operative). The need for additional analgesia and mean VAS of those in the placebo group was significantly higher than that of the study group with higher overall satisfaction rate in the study group (t = 7.18. CI 2.62 - 6.71. P < 0.0001). Conclusions: Paracervical block with 1% lignocaine is more effective in reducing pain during manual vacuum aspiration compared to placebo. It has added advantage of a higher overall satisfaction rate and reduced need for additional analgesia.