Patient-controlled analgesia an attractive pain management option during abortion

Oxycodone delivery via intravenous patient-controlled analgesia (IVPCA) allows women to self-administer analgesics when experiencing pain during medical abortion, helping reduce pain to mild or tolerable levels, according to a study.

The study included 99 women (median age 23 years) undergoing medically induced abortion between 64 to 128 days of gestation. They were randomized to receive oxycodone either via IVPCA (n=48) or given on-demand (n=51) orally, intramuscularly, or intravenously.

Twenty-four percent of the study population comprised teenagers (aged 15–19 years old). Most of the participants (85.9 percent, n=85) requested an abortion late in the first-trimester (between 64 and 84 days of gestation).

Researchers measured the study outcomes of pain intensity and satisfaction using the visual analogue scale (VAS, 0–100 mm). The median maximal pain VAS was 70 overall, with no difference between the study groups. A total of 46.5 percent women reported experiencing severe pain during medical abortion (VAS ≥70).

Women in both groups were equally likely to experience severe pain (highest pain VAS ≥70; IVPCA vs on-demand: odds ratio [OR], 0.51, 95 percent confidence interval [CI], 0.22–1.18; p=0.118). However, the IVPCA group was four times as likely as the on-demand group to achieve mild or tolerable pain (highest pain VAS ≤40; OR, 4.06, 95 percent CI, 1.05–16.04; p=0.043).

Despite the difference, satisfaction with care was high (VAS 94) in both groups. Of the women who experienced severe pain, 94.0 percent state that their pain medication was adequate.