A prospective observational study to determine the incidence and extent of postoperative pain following uterine evacuations and manual vacuum aspiration: a pilot study.
Date
2013-03-18
Authors
Mostert, Estie
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
BACKGROUND
Uterine evacuation (EVAC) and manual vacuum aspiration (MVA) are commonly performed minor gynaecological procedures, often being done on an out-patient basis. These procedures are associated with pain, but the severity and extent of the pain experienced, especially in the post-procedure period, is not well studied.
OBJECTIVES
The aim of this study was to determine whether patients who underwent EVAC and MVA procedures, experienced pain postoperatively; and if so, to quantify the degree of pain experienced. These patients were at Chris Hani Baragwanath Academic Hospital (CHBAH).
The objectives of this study were to determine whether patients (having undergone EVAC and MVA) experienced pain postoperatively, and to also determine the intensity of the pain. Additionally, to ascertain whether patient age, gestational age or the duration of the procedure, had any impact on the pain experienced. METHOD
A sample of 53 patients were selected, presenting for EVAC and MVA at CHBAH. There were 26 patients in the EVAC group and 27 in the MVA group. Information was collected from patient interviews and their hospital files and subsequently recorded on data sheets. Data collected on each data sheet included: patient age, gestation, procedure (EVAC or MVA), reason for procedure, length/duration of procedure and analgesia received prior to and during the procedure.
Pain was assessed at intervals of 10 minutes, 40 minutes, 2 hours and 3 hours post-procedure. This was achieved using a ratio, which was determined from a visual analogue scale (VAS). Patients who had pain greater than 3/10 on the VAS score, received rescue analgesia in the form of diclofenac, 1mg/kg diluted in 250 ml of Ringer‘s lactate, over 30 minutes intravenously.
RESULTS
Patients in the MVA group experienced significantly more pain immediately postoperatively than the patients in the EVAC group. However, there were no significant differences found in pain experienced between the two groups at 40 minutes and thereafter. CONCLUSION
Patients undergoing EVAC do experience pain, but if multimodal analgesia is provided, the pain experienced is not significant. Patients undergoing MVA experience significant pain post-procedure. It is recommended that improved analgesia protocols should be instituted.