Paracervical block and elective abortion: The effect on pain of waiting between injection and procedure

Objective: Our purpose was to assess the effect on pain and patient satisfaction of waiting between paracervical block and dilation during first-trimester abortions. Study Design: One hundred ninety-nine women seeking pregnancy termination were randomly assigned to a no-wait group (group 1) and a 3- to 5-minute wait between injection and dilation group (group 2). Subjects rated their pain on a visual analog scale at four times: prior to procedure, with dilation, with aspiration, and 30 to 45 minutes after procedure. Results: No significant differences were observed in pain or satisfaction ratings reported by group 1 (n = 93) and group 2 (n = 101). A significant decrease in pain with dilation (1.21 cm decrease, P = .009) and aspiration (1.15 cm decrease, P = .0015) was observed among patients who received fentanyl. Conclusion: Delay between paracervical injection and dilation during first-trimester abortion does not have an impact on patient pain or satisfaction. Fentanyl decreased pain scores by 20% to 25% during the procedure. (Am J Obstet Gynecol 2002;186:1304-7.)