Pain relief using paracervical block in patients undergoing manual vacuum aspiration of uterus

Abstract

Objective: To evaluate pain relief using paracervical nerve block with 1% lignocaine injection in patients undergoing uterine evacuation by Manual Vacuum Aspiration (MVA) for the treatment of incomplete abortion. Design: A randomized double blind clinical trial. Setting: Marie Stopes Health Centre, Nairobi. Methods: One hundred and forty two patients were recruited between September and October 1997. The intervention was random assignment to the study group (paracervical block with 1% lignocaine) or the placebo group (paracervical block with sterile water for injection). Intra and post operative assessment of pain was made using McGills and facial expression scales. Results: The untreated group experienced significantly more pain than the treated group, especially lower abdominal pain and backache. The pain was especially marked intra-operatively, less so 30 minutes post-operatively. Conclusion: Based on the findings of this study, any patient going for manual vacuum aspiration for the treatment of incomplete abortion should be given Paracervical block as it is cost effective, easy to perform and with less side effects.