Addition of buprenorphine to paracervical block prior to osmotic dilator insertion for dilation and evacuation: A randomized controlled trial
Abortion
Awarded 2020
Complex Family Planning Fellowship Research
Nicole Economou, MD
University of California, San Diego
$14,965

Cervical preparation with osmotic dilators is commonly used prior to dilation and evacuation procedures to decrease the risk of complications. Women have described the pain of dilator insertion as moderate to severe yet there have been few studies aimed at addressing pain during and after dilator insertion. This study will be a randomized controlled trial investigating the addition of buprenorphine to lidocaine in a paracervical block compared to a lidocaine paracervical block alone to decrease pain associated with osmotic dilator insertion. Our primary objective is to compare the median pain score (self-reported on the numeric rating scale) at the time of dilator insertion in women randomized to a lidocaine and buprenorphine paracervical block compared to a lidocaine paracervical block alone. We will also be comparing the median reported pain score 2 hours after osmotic dilator insertion. Participants will be stratified by vaginal parity (vaginally nulliparous versus vaginally multiparous) and another secondary outcome is to examine median pain scores at the time of dilator insertion by parity. We hypothesize that the addition of buprenorphine to a paracervical block using lidocaine will be associated with lower median pain scores at time of osmotic dilator insertion and 2 hours after osmotic dilator insertion compared to women who receive a lidocaine paracervical block alone.

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