Comparative effectiveness of four-point versus two-point paracervical block using 1% lidocaine for manual vacuum aspiration (MVA) in incomplete abortion: a randomized controlled trial

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Published May 11, 2024
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Vol. 8 No. 02 (2024): International Invention of Scientific Journal

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Ekundayo Oluwole Ayegbusi 1, Akintunde Olusegun Fehintola1, John Osaigbovoh Imaralu2, Adetola Abayomi Adeyeri 3, Abayomi Kolawole Ojo4, Benedict Tolulope Adeyanju5, Gbenga Damilola Akinlua5, Toyin Julius Oluleye5, Adebola Stella Ayegbusi6, Sodiq Mayowa Akinpelu5, Priscilla Iyeseni Ojo5, Esther Opeyemi Ajidahun1, Olawale Ayobami Abayomi7, Anthony Awolowo Thomas7, Babatunde Ajayi Olofinbiyi8,*.
1Department of Obstetrics, Gynaecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University / Teaching hospitals complex, Ile Ife, Osun State. Nigeria 2Department of Obstetrics and Gynaecology, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria 3Chinook Regional Hospital, 960 19 St S Lethbridge, Alberta, Canada. 4Department of Anaesthesia, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University / Teaching hospitals complex, Ile Ife, Osun State. Nigeria 5Department of Obstetrics and Gynaecology, College of Health Sciences, Afe Babalola University, Ado Ekiti, Ekiti State, Nigeria 6Deapartment of Nursing, Canterbury Christ Church University, Canterbury, Kent. England and Medway Maritime Hospital, NHS Foundation, Gillingham. Kent. UK 7Department of Radiology, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria. 8Department of Obstetrics and Gynaecology, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria.

Abstract

Background: Paracervical block is one of the mainstays for pain control during Manual Vacuum Aspiration of incomplete abortions. This study assessed the effectiveness of four versus two needle points paracervical block of 1% lignocaine, need for additional analgesia and satisfaction among women undergoing manual vacuum aspiration for incomplete abortion in OAUTHC, Ile-Ife.


Objective: Comparative effectiveness of four-point versus two-point paracervical block using 1% lidocaine for manual vacuum aspiration in incomplete abortion


Methods: One hundred and twenty women who were eligible for the study were randomized to two equal groups (A and B), a randomized controlled trial, conducted between January 2022 and February 2023. We analyzed the data using SPSS version 20. Paired T test, independent T test Chi square, and Fishers’ exact tests were applied for continuous and categorical variables as appropriate. P value < 0.05 was considered as statistically significant.


Results: The Intra-operative and Postoperative VAS was significantly higher in the two-point PCB group (group B) compared to the four-point PCB group (group A) (t = −3.37, CI −4.12 - −2.68. P < 0.05 intra-operative, t = 7.16, CI 2.63 - 4.63. P < 0.05 post-operative). The need for additional analgesia and mean VAS of those in the two-point group was significantly higher than that of the four-point group with higher overall satisfaction rate in the four-point group (t = 7.16. CI 2.63 - 6.88. P < 0.0001).


Conclusions: The four-point Paracervical block with 1% lignocaine is more effective in reducing pain during manual vacuum aspiration compared to the two-point paracervical block. It equally has added advantage of a higher overall satisfaction rate and reduced need for additional analgesia.


Keywords:  Abortion care, Manual vacuum aspiration, Four-point paracervical block, Two-point paracervical block

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Author Biography

Ekundayo Oluwole Ayegbusi 1, Akintunde Olusegun Fehintola1, John Osaigbovoh Imaralu2, Adetola Abayomi Adeyeri 3, Abayomi Kolawole Ojo4, Benedict Tolulope Adeyanju5, Gbenga Damilola Akinlua5, Toyin Julius Oluleye5, Adebola Stella Ayegbusi6, Sodiq Mayowa Akinpelu5, Priscilla Iyeseni Ojo5, Esther Opeyemi Ajidahun1, Olawale Ayobami Abayomi7, Anthony Awolowo Thomas7, Babatunde Ajayi Olofinbiyi8,*., 1Department of Obstetrics, Gynaecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University / Teaching hospitals complex, Ile Ife, Osun State. Nigeria 2Department of Obstetrics and Gynaecology, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria 3Chinook Regional Hospital, 960 19 St S Lethbridge, Alberta, Canada. 4Department of Anaesthesia, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University / Teaching hospitals complex, Ile Ife, Osun State. Nigeria 5Department of Obstetrics and Gynaecology, College of Health Sciences, Afe Babalola University, Ado Ekiti, Ekiti State, Nigeria 6Deapartment of Nursing, Canterbury Christ Church University, Canterbury, Kent. England and Medway Maritime Hospital, NHS Foundation, Gillingham. Kent. UK 7Department of Radiology, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria. 8Department of Obstetrics and Gynaecology, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria.

Ekundayo Oluwole Ayegbusi 1, Akintunde Olusegun Fehintola1, John Osaigbovoh Imaralu2, Adetola Abayomi Adeyeri 3, Abayomi Kolawole Ojo4, Benedict Tolulope Adeyanju5, Gbenga Damilola Akinlua5, Toyin Julius Oluleye5, Adebola Stella Ayegbusi6, Sodiq Mayowa Akinpelu5, Priscilla Iyeseni Ojo5, Esther Opeyemi Ajidahun1, Olawale Ayobami Abayomi7, Anthony Awolowo Thomas7, Babatunde Ajayi Olofinbiyi8,*.

1Department of Obstetrics, Gynaecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University / Teaching hospitals complex, Ile Ife, Osun State. Nigeria

2Department of Obstetrics and Gynaecology, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria

3Chinook Regional Hospital, 960 19 St S Lethbridge, Alberta, Canada.

4Department of Anaesthesia, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University / Teaching hospitals complex, Ile Ife, Osun State. Nigeria

5Department of Obstetrics and Gynaecology, College of Health Sciences, Afe Babalola University, Ado Ekiti, Ekiti State, Nigeria

6Deapartment of Nursing, Canterbury Christ Church University, Canterbury, Kent. England and Medway Maritime Hospital, NHS Foundation, Gillingham. Kent. UK

7Department of Radiology, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria.

8Department of Obstetrics and Gynaecology, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria.

 

How to Cite
Akinpelu5, Priscilla Iyeseni Ojo5, Esther Opeyemi Ajidahun1, Olawale Ayobami Abayomi7, Anthony Awolowo Thomas7, Babatunde Ajayi Olofinbiyi8,*., E. O. A. 1, A. O. F. J. O. I. A. A. A. 3, A. K. O. B. T. A. G. D. A. T. J. O. A. S. A. S. M. (2024). Comparative effectiveness of four-point versus two-point paracervical block using 1% lidocaine for manual vacuum aspiration (MVA) in incomplete abortion: a randomized controlled trial. International Invention of Scientific Journal, 8(02), Page: 35–42. Retrieved from https://iisj.in/index.php/iisj/article/view/413