Evaluation of Pain and Use of Analgesics during Medical Termination of Pregnancy in Real-Life Settings

Agostini, Aubert; Miquel, Laura; Herman-Demars, Hélène; Frantz, Sandrine; Sicot, Marie

doi:10.1007/s40122-023-00477-2

Cited by 1 publication

(2 citation statements)

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“…Nulliparous individuals generally have longer induction and labor times than multiparous individuals do, which justify the increased use of tablets. The use of analgesic medication and pain were significantly correlated with increased doses of prostaglandin analogs [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Sublingual sufentanil for patient-controlled analgesia during labor induction for pregnancy termination: an effective and well-tolerated approach

Fierro,

Milan,

Buelli

et al. 2024

J Anesth Analg Crit Care

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Background Effective pain management during labor induction for pregnancy termination is essential. However, to date, no effective treatment has been identified. The primary aim of this study was to measure the analgesic efficacy of a sufentanil sublingual tablet system during pregnancy termination and patient satisfaction by comparing nulliparous and multiparous women. The secondary aims were to characterize the safety profile by reporting any side effects or adverse events and to determine the need for rescue therapy. Methods We conducted an observational, retrospective, single-center study involving 48 women. The data retrieved for analysis included the total and hourly doses of sublingual sufentanil, evaluations of pain management satisfaction using a 5-point rating scale (ranging from 1, indicating “not satisfied” to 5, denoting “completely satisfied”), occurrence of side effects and adverse events, and the rate of rescue analgesic use. Categorical and numerical variables were compared between the two groups, and a correlation analysis was performed. Results The median total dose of sufentanil required was 60 mcg. Nulliparous women required a higher dose of sufentanil compared with multiparous women (105 mcg vs. 45 mcg; P = 0.01). Additionally, they underwent a longer labor, indirectly measured by the time of device usage (625 min vs. 165 min; P = 0.05). Regarding satisfaction, 40 patients (83.4%) were satisfied or completely satisfied, whereas only 8 patients (16.6%) reported dissatisfaction. Multiparous women exhibited higher satisfaction levels than did nulliparous women (P = 0.03). No adverse events were reported, and the most common side effects were nausea and vomiting (31.2%). Four patients (12%) required acetaminophen due to insufficient analgesia, with only one patient necessitating a switch to intravenous morphine. Conclusions Sublingual sufentanil was effective in both nulliparous and multiparous women with minimal side effects. Therefore, sublingual sufentanil can be considered a valid strategy for analgesia during labor induction for pregnancy termination.

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Section: Discussionmentioning

confidence: 99%

“…One explanation for this result is the heterogeneity of patients undergoing TOP in terms of parity, gestational age, and cause of TOP (medical abortion or intrauterine fetal death). This emphasizes the importance of patient-controlled analgesia [ 12 ] and suggests that analgesic prophylaxis may be unnecessary [ 21 ].…”

Section: Discussionmentioning

confidence: 99%