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

Abstract

Objective. To decrease the pain caused by the the Manual Vacuum Aspiration (MVA) in patients undergoing surgery from paracervical block.

Methodology. With a blind randomized controlled trial, eighty patients -two groups of forty- were selected for the treatment of incomplete abortion by Manual Vacuum Aspiration in the Department of Gynecology and Obstretrics in Vicente Corral Moscoso Hospital. Group “B” (n=40) underwent the paracervical block procedure. Besides paracervical block treatment, group “A” (n=40) received 1mcg/kg of intravenous remifentanil as an initial dose followed by 0,5mcg/ kg of bolus every four minutes. Pain intensity was measured using the visual analog scale of 10 points, haemodynamic changes and side effects.

Results. There is not a significant difference between the study groups related to age (p=0,118), weight (p = 0,522), height (p = 0,114), IMC (p = 0,668), level of education (p = 0,699). The use of remifentanil decreased the pain according to the visual analog scale (VAS) from 7,58 group “B” to 2,98 in group “A” (p = 0,000). There were not significant changes regarding mean arterial pressure and heart rate (p > 0,05). The side effect that showed a significant difference between the groups was the nausea (p = 0,001) which was higher in group “B”

Discussion. The use of remifentanil to paracervical block decresaed the VAS pain by 46% with major changes in hemodynamics and with fewer side effects than the control group having nausea (92.3% with p 0.001)

KEY WORDS. INCOMPLETE ABORTION, ANALGESIA, INTERMITTENT BOLUS, REMIFENTANIL, PARACERVICAL BLOCK LIDOCAINE, MVA, VAS PAIN