Assessment of Non-Pharmacologic Patient-Centered Pain Control Adjuncts on Pain Scores during First Trimester Abortion.
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2017-05
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Abstract
Objectives: The objective of this study is to review the literature regarding non-pharmacologic pain management techniques during first trimester abortion and to determine if a patient-centered approach to non-pharmacologic pain management is associated with lower pain scores during a first-trimester surgical abortion.
Study Design: Chapter one contains an integrative review of the literature regarding predictors of pain during first trimester abortion and of the efficacy of non-pharmacologic pain management techniques. Chapter two presents a randomized controlled trial of a patient-centered non-pharmacologic pain management approach during first trimester surgical abortion.
Results: The integrative review found that pre-procedure anxiety and depression are associated with increased pain during first-trimester surgical abortion. The trials of non-pharmacologic pain management techniques found that none of the interventions had a significant impact on pain scores during the procedure. The randomized controlled trial presented in Chapter Two found no difference between the intervention (patient-centered non-pharmacologic pain management) and control (standard care) groups.
Conclusions: Anxiety, depression and isolation have consistently been shown to be a good predictor of patient pain levels during first-trimester surgical abortion. The studies in the integrative review and the randomized controlled trial attempted to mitigate these impacts through non-pharmacologic pain management techniques. While none of the trials demonstrated an association between these techniques and reduced pain scores,
patients were consistently positive about the use of these techniques. Adding these interventions to clinical practice could be a low-cost, low-risk quality improvement measure.
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pain, non-pharmacologic, abortion
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