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Randomized Controlled Trial
. 2023 Sep;23(3):8-16.
doi: 10.4314/ahs.v23i3.4.

A comparative study on the effectiveness of paracervical block and parenteral diclofenac for pain relief during manual vacuum aspiration

Iyke F Osinachi  1 , Godwin O Akaba  2 , Nathaniel D Adewole  2 , Kate I Omonua  2 , Bissallah A Ekele  1
Affiliations
Randomized Controlled Trial

A comparative study on the effectiveness of paracervical block and parenteral diclofenac for pain relief during manual vacuum aspiration

Iyke F Osinachi et al. Afr Health Sci. 2023 Sep.

Abstract

Objective: To compare the effectiveness of paracervical block with intramuscular Diclofenac for pain relief during manual vacuum aspiration (MVA) for early pregnancy losses.

Methodology: This was an open label randomized controlled trial. Participants were randomized into two therapeutic groups (A and B) using computer generated numbers. Group A received intramuscular Diclofenac 75 mg. Group B received paracervical block using 1% Lidocaine. Participants were asked to rate their pain level on a continuous 10 cm visual analogue scale (VAS) from 0 (no pain) to 10 (the worst pain ever) within 5 minutes of completing the procedure. Participants' level of satisfaction was assessed within 30 minutes of completing the MVA using Likert scale. Data was analysed using the Statistical Package for Social Sciences (SPSS), Version 20. Test of statistical significance was set at 95% confidence level (P < 0.05). The primary outcome was the level of pain felt by the patient during the procedure (10 cm VAS). Secondary outcomes included patient's satisfaction and adverse events.

Results: There was significant difference in the mean pain level between the intramuscular diclofenac group; 6.5±1.5 (moderate) and those that received paracervical block; 2.3±1.5 (mild), (p-value=0.005). Patients' satisfaction was also better in paracervical block group compared to intramuscular diclofenac group, (p-value=0.005). Both groups were comparable in terms of complications and drug side effects.

Conclusion: Findings from the study suggest that the use of paracervical block compared to intramuscular Diclofenac for pain relief during MVA for incomplete miscarriage significantly reduced pain, improved patients' satisfaction and was comparably safe.

Keywords: Diclofenac; Manual vacuum aspiration; Pain relief; Paracervical block.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Consort Flow Chart Adapted from CONSORT 2010 flow diagram
See this image and copyright information in PMC

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