Remifentanilo como analgesia complementaria en bloqueo paracervical para aspiración manual endouterina. Hospital Vicente Corral Moscoso. Cuenca, 2013

Abstract

OBJECTIVE: To reduce the pain of manual vacuum aspiration (MVA) in patients involved under paracervical block. MATERIALS AND METHODS: In a clinical randomized controlled blind design, 80 patients were included (in two groups of 40) selected for an incomplete treatment of abortion with manual vacuum aspiration, in the Gynecology and Obstetrics Department of the Vicente Corral Moscoso Hospital. The group “A” (n = 40) received additional to the paracervical block 1 mcg / kg intravenous remifentanil as an initial dose followed by 0.5 mcg / kg every 4 minutes and the group “B” (n = 40), the procedure was performed only under paracervical. Pain intensity was determined by visual analog scale of 10 points, hemodynamic changes and side effects. RESULTS: There is no a significant difference in the study groups in both age (p = 0.118), weight (p = 0.522), height (p = 0.114), BMI (p = 0.668), educational level (p = 0.699). The addition of remifentanil, reduced pain according to the EVA of 7.58 group “B” with respect to 2.98 group “A”, (p = 0.000); it had no significant changes in arterial pressure and heart rate (p> 0.05); the side effect was presented with statistically significant difference (p = 0.001) it is nausea which is higher in group “B”. DISCUSSION: The addition of remifentanil to paracervical block, decreased the pain through EVA by 46%, without much change in hemodynamics and with fewer side effects than has the control group (92.3% nausea with p 0.001).