Prophylactic Pregabalin to Decrease Pain during Medical Abortion: A Randomized Controlled Trial.

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2017-05
Authors
Friedlander, EmmaKate B.
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Biomedical Sciences
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OBJECTIVE: To evaluate whether prophylactic pregabalin reduces the level of maximum pain experienced with mifepristone-misoprostol medical abortion. METHODS: We conducted a randomized, double-blind, placebo-controlled clinical trial of women initiating a medical abortion up to 70 days of gestation. After taking mifepristone, participants were randomized to a capsule of pregabalin 300 mg or a matched placebo to be taken at the time of buccal misoprostol. All participants were dispensed ibuprofen and oxycodone with acetaminophen as additional analgesia to be taken as needed. Electronic surveys were sent via text message link at six time points over 72 hours to assess the primary outcome of maximum pain, as well as secondary outcomes such as analgesic use and adverse effects. RESULTS: From June 2015 to October 2016, 110 women were randomized to receive 300 mg of pregabalin or a matched placebo. Demographic characteristics were similar between groups. The primary outcome of maximum pain score in the pregabalin group was 5.0 versus 5.5 in the placebo group (standard deviations 2.6 and 2.2, respectively; p=0.32). More participants in the pregabalin group did not need additional analgesia. No ibuprofen was taken by 27% of the pregabalin group versus 12% placebo (p=0.04). No oxycodone with acetaminophen was taken by 69% of the pregabalin group versus 50% placebo (p=0.04). Satisfaction scores for the abortion process were highest in the pregabalin group (very satisfied: 41% versus 22%; p=0.03), as were satisfaction scores for the analgesic regimen (very satisfied: 47% versus 22%; p=0.006). CONCLUSION: Maximum pain scores were not significantly different between the pregabalin and placebo groups, though women who received pregabalin were less likely to require any ibuprofen or oxycodone with acetaminophen, and were more likely to report higher satisfaction scores.
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medical abortion, pain, pregabalin
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