P–745 The efficacy of Buscopan® in reducing pain during ultrasound-guided manual vacuum aspiration (USG-MVA): A double-blind randomised placebo-controlled trial

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J P W Chung ◽  
T Law ◽  
D Sahota ◽  
J Mak ◽  
T C Li
Keyword(s):  
Abdominal Pain ◽  
Placebo Group ◽  
Intravenous Injection ◽  
Uterine Contraction ◽  
Controlled Trial ◽  
Ultrasound Guided ◽  
Patient Satisfaction Score ◽  
Vacuum Aspiration ◽  
Pain Scores ◽  
Manual Vacuum Aspiration

Abstract Study question Does Buscopan® reduce abdominal pain experienced by women undergoing ultrasound-guided manual vacuum aspiration (USG-MVA)? Summary answer The addition of 20mg Buscopan® intravenous injection was not associated with a statistical reduction in pain score but leads to a higher patient satisfaction score. What is known already Ultrasound-guided Manual Vacuum aspiration is a feasible and effective out-patient treatment option for treating early pregnancy loss. However, it is associated with a moderate amount of pain due to uterine contraction. Study design, size, duration This randomised, double-blinded, placebo-controlled trial was conducted in a university-affiliated tertiary hospital. The study assessed whether 1 ml of 20mg Buscopan® intravenous injection 5 minutes before the USG-MVA will reduce the abdominal pain experienced by the women immediately and 2 hours after the procedure. Participants were randomised between June 2018 to January 2020 using a computer-generated number series in a 1:1 ratio. Participants/materials, setting, methods Women aged 18 years or older with first-trimester miscarriage undergoing the USG-MVA procedure were eligible. In total, 122 participants out of 128 eligible were included. Of whom, 111 underwent the USG-MVA procedure, 60 randomised to the Buscopan® group, and 62 to the placebo group. Main results and the role of chance The median abdominal pain scores in the Buscopan® group were 16.0% and 21.2% lower than the placebo group immediately post-procedure and 2 hours after the procedure in the Buscopan® group. Repeated measures ANOVA indicated that the both vaginal and abdominal pain scores improved significantly with the time (Vaginal F(1,108)=180.1,p<0.0001; Abdominal: F(1,108)=83.41,p<0.001) but not with group. No difference was noted in the complications and side effects profile. The physiological stress measured by Log10 sAA levels reduced significantly with time (F(2.8,286.1)= 6.3, p < 0.001) but not with group (F = 0.1, p = 0.96). Women randomised to Buscopan® had a significantly higher (p = 0.032) mean VAS satisfaction scores compared to those receiving placebo (79.0±17.3 vs 73.4±24.1). Limitations, reasons for caution This study was a single-centre study, thus one should be cautious in the overall generalisability of the results. Wider implications of the findings: Few studies have evaluated the use of anti-spasmodic agents to minimise uterine contraction pain in women undergoing outpatient uterine evacuation. We consider Buscopan® a useful adjunct in the pain control of USG-MVA to specifically reduce uterine cramps. Further larger studies are required to evaluate its efficacy. Trial registration number ChiCTR1800014590

P-745 The efficacy of Buscopan® in reducing pain during ultrasound-guided manual vacuum aspiration (USG-MVA): A double-blind randomised placebo-controlled trial

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J P W Chung ◽  
T Law ◽  
D Sahota ◽  
J Mak ◽  
T C Li
Keyword(s):  
Abdominal Pain ◽  
Placebo Group ◽  
Intravenous Injection ◽  
Uterine Contraction ◽  
Controlled Trial ◽  
Ultrasound Guided ◽  
Patient Satisfaction Score ◽  
Vacuum Aspiration ◽  
Pain Scores ◽  
Manual Vacuum Aspiration

Abstract Study question Does Buscopan® reduce abdominal pain experienced by women undergoing ultrasound-guided manual vacuum aspiration (USG-MVA)? Summary answer The addition of 20mg Buscopan® intravenous injection was not associated with a statistical reduction in pain score but leads to a higher patient satisfaction score. What is known already Ultrasound-guided Manual Vacuum aspiration is a feasible and effective out-patient treatment option for treating early pregnancy loss. However, it is associated with a moderate amount of pain due to uterine contraction. Study design, size, duration This randomised, double-blinded, placebo-controlled trial was conducted in a university-affiliated tertiary hospital. The study assessed whether 1 ml of 20mg Buscopan® intravenous injection 5 minutes before the USG-MVA will reduce the abdominal pain experienced by the women immediately and 2 hours after the procedure. Participants were randomised between June 2018 to January 2020 using a computer-generated number series in a 1:1 ratio. Participants/materials, setting, methods Women aged 18 years or older with first-trimester miscarriage undergoing the USG-MVA procedure were eligible. In total, 122 participants out of 128 eligible were included. Of whom, 111 underwent the USG-MVA procedure, 60 randomised to the Buscopan® group, and 62 to the placebo group. Main results and the role of chance The median abdominal pain scores in the Buscopan® group were 16.0% and 21.2% lower than the placebo group immediately post-procedure and 2 hours after the procedure in the Buscopan® group. Repeated measures ANOVA indicated that the both vaginal and abdominal pain scores improved significantly with the time (Vaginal F(1,108)= 180.1,p<0.0001; Abdominal F(1,108)=83.41,p<0.001) but not with group. No difference was noted in the complications and side effects profile. The physiological stress measured by Log10 sAA levels reduced significantly with time (F(2.8,286.1)= 6.3, p < 0.001) but not with group (F = 0.1, p = 0.96). Women randomised to Buscopan® had a significantly higher (p = 0.032) mean VAS satisfaction scores compared to those receiving placebo (79.0±17.3 vs 73.4±24.1). Limitations, reasons for caution This study was a single-centre study, thus one should be cautious in the overall generalisability of the results. Wider implications of the findings Few studies have evaluated the use of anti-spasmodic agents to minimise uterine contraction pain in women undergoing outpatient uterine evacuation. We consider Buscopan® a useful adjunct in the pain control of USG-MVA to specifically reduce uterine cramps. Further larger studies are required to evaluate its efficacy Trial registration number ChiCTR1800014590

Incomplete miscarriage during the first trimester: a comparison of indoor versus outdoor procedure

2020 ◽  
Vol 24 (3) ◽  
pp. 235-239
Author(s):  
Faiza Iqbal ◽  
Sadia Azmat ◽  
Rabia Jamshaid ◽  
Zunaira Arshad ◽  
Anum Saqib
Keyword(s):  
Controlled Trial ◽  
First Trimester ◽  
P Value ◽  
Vacuum Aspiration ◽  
Manual Vacuum Aspiration ◽  
Group A ◽  
First Trimester Of Pregnancy ◽  
The Mean ◽  
Group B ◽  
Incomplete Miscarriage

Introduction: Miscarriage is defined as the natural death of a fetus inside the uterus. To remove complete conception material after a miscarriage, vacuum aspiration or dilatation & curettage are methods to remove uterine contents. Controversies exist regarding both procedures. So we conducted this study to confirm the more successful method. Objective: To compare the effectiveness of manual vacuum aspiration versus traditional evacuation and curettage (E & C) among females presenting with incomplete miscarriage during the first trimester of pregnancy Materials and Methods: This randomized controlled trial was done at the Department of Obstetrics & Gynecology, Shalamar Hospital, Lahore for 6 months. Then the selected females were divided randomly into 2 equal groups. In group A, females had manual vacuum procedure while in group B, females had evacuation & curettage under general anesthesia. After 12 hours of the procedure, ultrasonography was done to confirm complete evacuation. Results: The mean age of the patients was 29.87 ± 6.71 years, the mean gestational age was 8.06 ± 2.82 weeks. The effectiveness was noted in 248 (91.85%) patients. Statistically, manual vacuum showed significantly more effective as compared to evacuation & curettage procedure in the management of incomplete miscarriage i.e. p-value = 0.008. Conclusion: It has been proved that manual vacuum aspiration is more effective than traditional evacuation & curettage in the management of incomplete miscarriage.

scholarly journals Premedication with Oral Paracetamol for Reduction of Propofol Injection Pain: A Randomized Placebo-Controlled Trial

2019 ◽  
Author(s):  
Sasikaan Nimmaanrat ◽  
Manasanun Jongjidpranitarn ◽  
Sumidtra Prathep ◽  
Maliwan Oofuvong
Keyword(s):  
Placebo Group ◽  
Intravenous Injection ◽  
Controlled Trial ◽  
Injection Pain ◽  
Rating Score ◽  
Double Blind ◽  
Randomized Controlled ◽  
Numerical Rating ◽  
Injection Methods ◽  
Different Doses

Abstract Background: To compare the effect of premedication with 2 different doses of oral paracetamol to prevent pain at propofol intravenous injection. Methods: We conducted a double-blind randomized controlled trial in which patients scheduled for induction of general anesthesia with intravenous propofol received either a placebo, 500 mg or 1000 mg of oral paracetamol (P500 and P1000, respectively) 1 hr prior to induction. Two mg/kg of propofol was injected at a rate of 600 ml/hr. After 1/4 of the full dose had been injected, the syringe pump was paused, and patients were asked to rate pain at the injection site using a verbal numerical rating score (VNRS) from 0-10. Results: Three hundred and twenty-four patients were included. Pain intensity was lower in both P500 and P1000 groups (median VNRS [interquartile range] = 2 [0-3] and 4 [2-5], respectively) than in the placebo group (8 [7-10]; P<0.001)*. The rate of pain was lower in the P1000 group (70.4%) than in both the P500 and the placebo group (86.1% and 99.1%, respectively; P<0.001)*. The respective rates of mild (VNRS 1-3), moderate (VNRS 4-6) and severe pain (VNRS 7-10) were 47.2, 23.2 and 0% in the P1000 group, 28.7, 50 and 7.4% in the P500 group, and 0, 22.2 and 76.9% in the placebo group (P<0.001* for between group comparisons). Tolerance was similar in the 3 groups. Conclusions: A premedication with oral paracetamol can dose-dependently reduce pain at propofol intravenous injection. To avoid this common uncomfortable concern for the patients, this well-tolerated, available and cheap treatment appears as an option to be implemented in the current practice.

scholarly journals Analgesic Efficacy of Paracervical Block for Manual Vacuum Aspiration of Incomplete Abortions: A Randomized Controlled Trial

2021 ◽  
Vol 11 (08) ◽  
pp. 955-972
Author(s):  
Ekundayo O. Ayegbusi ◽  
Akintunde O. Fehintola ◽  
Akinyosoye D. Ajiboye ◽  
Ayodele Idowu ◽  
Tope O. Okunola ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Analgesic Efficacy ◽  
Randomized Controlled ◽  
Vacuum Aspiration ◽  
Manual Vacuum Aspiration ◽  
Paracervical Block

scholarly journals Premedication with Oral Paracetamol for Reduction of Propofol Injection Pain: A Randomized Placebo-Controlled Trial

2019 ◽  
Author(s):  
Sasikaan Nimmaanrat ◽  
Manasanun Jongjidpranitarn ◽  
Sumidtra Prathep ◽  
Maliwan Oofuvong
Keyword(s):  
Placebo Group ◽  
Intravenous Injection ◽  
Controlled Trial ◽  
Injection Pain ◽  
Rating Score ◽  
Double Blind ◽  
Randomized Controlled ◽  
Numerical Rating ◽  
Injection Methods ◽  
Different Doses

Abstract Background: To compare the effect of premedication with 2 different doses of oral paracetamol to prevent pain at propofol intravenous injection. Methods: We conducted a double-blind randomized controlled trial in which patients scheduled for induction of general anesthesia with intravenous propofol received either a placebo, 500 mg or 1000 mg of oral paracetamol (P500 and P1000, respectively) 1 hr prior to induction. Two mg/kg of propofol was injected at a rate of 600 ml/hr. After 1/4 of the full dose had been injected, the syringe pump was paused, and patients were asked to rate pain at the injection site using a verbal numerical rating score (VNRS) from 0-10. Results: Three hundred and twenty-four patients were included. Pain intensity was lower in both P500 and P1000 groups (median VNRS [interquartile range] = 2 [0-3] and 4 [2-5], respectively) than in the placebo group (8 [7-10]; P<0.001)*. The rate of pain was lower in the P1000 group (70.4%) than in both the P500 and the placebo group (86.1% and 99.1%, respectively; P<0.001)*. The respective rates of mild (VNRS 1-3), moderate (VNRS 4-6) and severe pain (VNRS 7-10) were 47.2, 23.2 and 0% in the P1000 group, 28.7, 50 and 7.4% in the P500 group, and 0, 22.2 and 76.9% in the placebo group (P<0.001* for between group comparisons). Tolerance was similar in the 3 groups. Conclusions: A premedication with oral paracetamol can dose-dependently reduce pain at propofol intravenous injection. To avoid this common uncomfortable concern for the patients, this well-tolerated, available and cheap treatment appears as an option to be implemented in the current practice.

LO36: Hyoscine butylbromide (Buscopan) for abdominal pain in children: a randomized controlled trial

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S20
Author(s):  
N. Poonai ◽  
S. Elsie ◽  
K. Kumar ◽  
K. Coriolano ◽  
S. Brahmbhatt ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Adverse Effects ◽  
Controlled Trial ◽  
Common Adverse Effect ◽  
Functional Abdominal Pain ◽  
Hyoscine Butylbromide ◽  
Caregiver Satisfaction ◽  
Intention To Treat ◽  
Pain Scores ◽  
The Mean

Introduction: Abdominal pain is one of the most frequent reasons for an emergency department (ED) visit. Most cases are functional and no therapy has proven effective. Our objective was to determine if hyoscine butylbromide (HBB) (BuscopanTM) is effective for children who present to the ED with functional abdominal pain. Methods: We conducted a randomized, blinded, superiority trial comparing HBB 10 mg plus acetaminophen placebo to oral acetaminophen 15 mg/kg (max 975 mg) plus HBB placebo using a double-dummy approach. We included children 8-17 years presenting to the ED at London Health Sciences Centre with colicky abdominal pain rated &gt;40 mm on a 100 mm visual analog scale (VAS). The primary outcome was VAS pain score at 80 minutes post-administration. Secondary outcomes included adverse effects; caregiver satisfaction with pain management using a five-item Likert scale; recidivism and missed surgical diagnoses within 24-hours of discharge. Analysis was based on intention to treat. Results: We analyzed 225 participants (112 acetaminophen; 113 HBB). The mean (SD) age was 12.4 (3.0) years and 148/225 (65.8%) were females. Prior to enrollment, the median (IQR) duration of pain prior was 2 (4.5) hours and analgesia was provided to 101/225 (44.9%) of participants. The mean (SD) pre-intervention pain scores in the acetaminophen and HBB groups were 62.7 (15.9) mm and 60.3 (17.3) mm, respectively. At 80 minutes, the mean (SD) pain scores in the acetaminophen and HBB groups were 30.1 (28.8) mm and 29.4 (26.4) mm, respectively and there were no significant differences adjusting for pre-intervention scores (p = 0.96). The median (IQR) caregiver satisfaction was high in the acetaminophen [5 (2)] and HBB [5 (1)] groups (p = 0.79). The median (IQR) length of stay between acetaminophen [235 (101)] and HBB [234 (103)] was not significantly different (p = 0.53). The proportion of participants with a return visit for abdominal pain was 4/112 (3.5%) in the acetaminophen group and 6/113 (5.3%) in the HBB group. The most common adverse effect was nausea (9% in each group) and there were no significant differences in adverse effects between acetaminophen (26/112, 23.2%) and HBB (31/113, 27.4%) (p = 0.52). There were no missed surgical diagnoses. Conclusion: For children with presumed functional abdominal pain who present to the ED, both acetaminophen and HBB produce a clinically important (VAS &lt; 30 mm) reduction in pain and should be routinely considered in this clinical setting.

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