Objective: To reduce the pain experienced during abortion.
Methods: A four-phase study was conducted at a free-standing abortion clinic. Phase 1: a double-blind, randomized, placebo-controlled trial of 600 mg ibuprofen given preoperatively was carried out in 193 women. Pain during the procedure and 30 min postoperatively was compared. Phase 2: a double-blind, randomized trial compared 1% lidocaine, buffered 1% lidocaine and 0.25% bupivacaine in terms of the pain of the injection and the pain of the procedure in 200 women. Phase 3: waiting times of 0, 3 and 10-20 min between the end of the injection and the beginning of the procedure were compared in terms of pain during the procedure in 139 women. Phase 4: local anesthetic was injected into one side of the cervix slowly and one side quickly and the pain of the injections was compared in 87 women.
Results: Phase 1: ibuprofen reduced pain scores more than placebo with the improvement being greatest for the postoperative period. Phase 2: buffered lidocaine was significantly less painful to inject than plain lidocaine or bupivacaine. Phase 3: waiting between the injection and the procedure did not improve pain control. Phase 4: slower injections were found to be less painful than fast injections.
Conclusions: Several methods were found to improve pain control during abortions.