Diazepam as a sedative in induced abortion

Abstract

In 136 patients, who underwent induced abortion by the vacuum curettage method under local anaesthesia (paracervical block), the effect of 10 mg diazepam intravenously as preoperative sedative was investigated for its ability to abolish the subjective experience of pain. The trial was carried out as a paired sample, random, allocation, double-blind, fixed dose trial, and the statistical method was sequential analysis. Thirty-six pairs showed no difference and were excluded. After 32 pairs (24 A preferences and 8 O preferences), diazepam showed a significant superiority to placebo (p less than 0.05) (Fig. 1.) Amnesia for the procedure was reported by about one-quarter of the diazepam-treated patients, and in practically all cases the sedative effect had subsided 1-3 hours after the operation.

PIP: Diazepam has been reported to reduce pain and discomfort and in many cases to produce a total amnesia. The drug was tested with 136 patients undergoing vacuum curettage for abortion. About 1/2 hour before the pro cedure, patients received premedication with 50 mg pethidine sc. At the beginning of the procedure, half the patients received 10 mg diazepam iv , and the other half a placebo. Paracervical block was then used with 1 % carbocaine. After 3 minutes, the cervix was dilated with a Hegar dila tor, the uterine contents were removed by the suction curette, and .2 mg methyl-ergometrine maleate (Methergin) was given iv. At 1-3 hours posto peratively, patients were asked if the operation had been painful. In 36 instances no preference was shown between results. In 32 instances w here a preference was shown diazepam was considered superior to the plac ebo in reducing pain and discomfort in 24 patients. In 18 of the 68 pat ients treated with diazepam, there was total amnesia for the procedure. However, 2 patients receiving the placebo also had amnesia. At 1-3 hours after the procedure, 4 patients in the diazepam group and 3 in the placebo group were slightly somnolent. With the dose used, the procedure can be done on an outpatient basis.