A comparative study of safety and patient satisfaction of combined intramuscular acetaminophen- diclofenac versus acetaminophen-pentazocine for pain relief during manual vacuum aspiration in university of Maiduguri teaching hospital: Randomised controlled

Background. The management of first trimester miscarriages using manual vacuum aspiration is a cheap, fast and safe surgical method of uterine evacuation. However, this procedure cause pain as a result of cervical manipulation, insertion of cannula and suctioning of uterine cavity. Therefore, an effective and safe pain management intervention is necessary to minimise this pain and reduces side effect of the medication.

Objective: To determine and compare the side effects and participants’ satisfaction of combined acetaminophen-diclofenac versus acetaminophen-pentazocine for pain relief during manual vacuum aspiration.

Methodology: This was a triple-blind randomised controlled study, that compared the side effects and participant satisfaction of combined acetaminophen-diclofenac versus acetaminophen-pentazocine as a multimodal analgesia during manual vacuum aspiration. A total of 112 participants were randomised into two groups. Participants in group A (56 patients) received combined acetaminophen-diclofenac while participants allocated in group B (56 patients) received acetaminophen-pentazocine for pain relief during manual vacuum aspiration. 

The outcome measured were the side effects and participants’ satisfaction with analgesia given during the procedure. The data was entered into SPSS version 20.0 (IBM, Armonk, NY, USA 2011) for statistical analysis. 

Result: Participants in combined acetaminophen-diclofenac group had less side effects compared to participant in combined acetaminophen-pentazocine group, and it was statistically significant for dizziness (P value = 0.001), nausea (P value=0.046) and weakness (P value=0.001). There was statistically significant difference in participants satisfaction in both groups (P value = 0.009). Greater number 48(85.7%) of participants in the acetaminophen-pentazocine group were satisfied compared to 36(64.3%) participants in the acetaminophen-diclofenac group.

Conclusion:  Combined acetaminophen-pentazocine as a form of analgesia during MVA provided more satisfaction, although it had a higher side effect profile, when compared to combined acetaminophen-diclofenac.