Svetlana Radeva
Medical University of Varna - Faculty of Public Health
Specialized hospital of obstetrics and gynecology for active treatment – Varna, Bulgaria
DOI : https://doi.org/10.47191/ijmra/v7-i01-22Google Scholar Download Pdf
ABSTRACT:
Review of the current literature on pain prevention in induced abortion.An in - depth analysis of the guidelines of leading international and national organizations
for prophylaxis of induced abortion-surgical and medicated abortion during the I-st and II-nd trimester in terms of pain response has been carried out. Shared with the
author's many years of practical experience in order to assess the risks and benefits of the application of modern means of prophylaxis in artificial abortion and thus
to improve the individual obstetric-gynecological practice.
Methods: review of available literature from the last 10 years.
Results and discussion:Paracetamol, oral lorazepam and nitric oxide do not improve pain control. Currently, the use of sedation is not recommended for Surgical abortion.
Inhalation anaesthesia should not be used for sedation. Intravenous sedation with fentanyl and midazolam is recommended and safe - below 1.0% complications.
In Medical abortion, 75.0% of women experience pain severe enough to require analgesia. The pain begins 2.5 to 4 hours after the use of perplex and
lasts about an hour. During the extravehicular trimester, taking a higher number of doses intravenously is associated with more severe and frequent pain.
In medicated abortion < 14 gw. non-steroidal anti-inflammatory drugs are recommended 30-45 minutes before the procedure. Non-steroidal medicines do not reduce
the efficacy of urgencies. Routine administration of paracervical block before 13 gw. when using modern means for medicated abortion is unnecessary. Narcotic
analgesics (Tramadol) do not affect pain in early Medical abortion and their routine use is not recommended.
Conclusion:In Surgical abortion, analgesia is always offered. Most commonly, analgesics, such as non-steroidal anti-inflammatory drugs local anesthesia
(paracervical block with Lidocaine 20.1%; or 10.2%),) and/ or sedation, supplemented with verbal sedation, are sufficient to relieve pain before mechanical
cervical dilation and during uterine evacuation. The technique of deep paracervical injection of Lidocacaine at two points is recommended.
induced abortion, prophylactic, pregnancy
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2) Edelman, A. & Kapp, N. (2018). Dilatation & Evacuation (D&E) Reference Guide: Induced abortion and postabortion care at or after 13 weeks gestation (‘second trimester’). Chapel Hill, NC: Ipas.
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Volume 07 Issue 01 January 2024
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