Prophylactic Pregabalin to Decrease Pain during Medical Abortion: A Randomized Controlled Trial.
Date
2017-05
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Abstract
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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