Publication:

Comparative study of patients undergoing check curettage for first trimester incomplete and inevitable abortion under paracervical block versus no anesthesia

Background The pain experienced during check curettage is due to the dilatation of the cervix, hence it can be hypothesized that in patients with a dilated internal os there should be no need for anesthesia. If it can be proven, then it would prove useful in cases where access to anesthesia is not available, such as primitive hospital set up, while also reducing the cost and complications of anesthesia.

Methods This study was a prospective randomized single blinded control trial conducted in a tertiary care centre over a period of 15 months with a sample size of 80 patients, 40 in group receiving paracervical block and 40 in group receiving no anesthesia. All patients with spontaneous first trimester incomplete and inevitable abortion were included and randomized in the two groups. Intraoperative vital parameters, vocalization, limb movement and demand for higher anesthesia were noted. Postoperative pain score was obtained based on the numeric rating scale.

Results The demand for higher anesthesia and satisfaction with procedure was comparable between the two groups (P> 0.05).The average pain score for patients receiving paracervical block was 1.13 and that for patients receiving no anesthesia was 1.79 (P<0.05).

Conclusions The mean pain scores of both the groups were on the lower spectrum of the pain scale with no difference in demand for higher anesthesia. In primary set ups where facilities of anesthesia are not available, curettage can be performed safely without anesthesia, which can prove to be life-saving.