A randomized control trial comparing lignocaine and pethidine during MVA procedure in new mulago hospital.
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A Dissertation submitted in partial fulfillment of the requirements for the award of the degree of Master of Medicine in Obstetrics and Gynaecology of makerere universiy.
Abortions in uganda contribute substantially to maternal morbidity and mortality. Almost 20 million unsafe abortions take place every year globally and approximately 80,000 women die from complications related to abortions, mainly from hemorrhage and sepsis. Mannual vacuum aspiration introduced by Ipas africa alliance, has become increasingly a main method of evacuating the uterus following incomplete abortions, induced or spontaneous up to a gestation of 12 weeks. Pain being the main complaint, which brings every patient to a hospital to see a clinician should be addreesed while performing MVA. In lower mulago hospital, the mainstay of alleviating pain during MVA procedure id by giving opiod analgesics, morphine and pethidine. This study was meant to address pain management during MVA. STUDY OBJECTIVES: To comapre the use of para cervical block with lignocaine against itravenous for pain relief during MVA for incomplete abortions. To determine the level of patient satisfaction in respect of pain relief using a visual analog score following MVA. To determine the side effects if any, associated with lignocaine or pethidine during or after MVA. STUDY DESIGN:A randomised control trial STUDY SITE: The study was conducted at lower mulago national hospital, at Acute Gynecology ward(5A Annex). STUDY POPULATION: The study recruited patients with incomplete abortions of less than 12 weeks amenorrhea. All patients who were admitted in the ward 5A annex and met the inclusion criteria and consented for the study were recruited. Prior to the study, records from 5A-annex indicated that atleast six to ten patients of incomplete abortions are treated in the acute ward daily. During the study, a sample size of 182 was targeted and realised (100%).
Abortions in uganda contribute substantially to maternal morbidity and mortality. Almost 20 million unsafe abortions take place every year globally and approximately 80,000 women die from complications related to abortions, mainly from hemorrhage and sepsis. Mannual vacuum aspiration introduced by Ipas africa alliance, has become increasingly a main method of evacuating the uterus following incomplete abortions, induced or spontaneous up to a gestation of 12 weeks. Pain being the main complaint, which brings every patient to a hospital to see a clinician should be addreesed while performing MVA. In lower mulago hospital, the mainstay of alleviating pain during MVA procedure id by giving opiod analgesics, morphine and pethidine. This study was meant to address pain management during MVA. STUDY OBJECTIVES: To comapre the use of para cervical block with lignocaine against itravenous for pain relief during MVA for incomplete abortions. To determine the level of patient satisfaction in respect of pain relief using a visual analog score following MVA. To determine the side effects if any, associated with lignocaine or pethidine during or after MVA. STUDY DESIGN:A randomised control trial STUDY SITE: The study was conducted at lower mulago national hospital, at Acute Gynecology ward(5A Annex). STUDY POPULATION: The study recruited patients with incomplete abortions of less than 12 weeks amenorrhea. All patients who were admitted in the ward 5A annex and met the inclusion criteria and consented for the study were recruited. Prior to the study, records from 5A-annex indicated that atleast six to ten patients of incomplete abortions are treated in the acute ward daily. During the study, a sample size of 182 was targeted and realised (100%).
Keywords
Lignocaine, MVA procedure, New Mulago Hospital, Abortions, Uganda, Pethidine