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Prospective Randomized, Double-blinded, Placebo- Controlled Trial of Preoperative Acetaminophen/Tramadol for Pain Relief in Manual Vacuum Aspiration under Paracervical Block

Wanchat Komon MD 1 , Nathpong Israngura MD, MSc 1 , Sakda Arj-Ong Vallibhakara MD, PhD 2 , Chonthicha Satirapod MD 1

Affiliation : 1 Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand 2 Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand


Objective : To evaluate the analgesic efficacy of pre-operative administration of acetaminophen/tramadol (Ultracet) when compared to placebo in patients undergoing uterine manual vacuum aspiration (MVA) under a standard technique of paracervical block.
Materials and Methods : This double-blinded, randomized, concealed allocation, placebo-controlled trial enrolled 220 women who underwent MVA under a standard technique of paracervical block. One hundred and ten women were randomly assigned to receive ultracet and the others to placebo. The primary outcome was to assess the intensity of pain after procedure in term of visual analog pain score. Student’s t -tests and Chi-squared test were used to analyze data as proper.
Results : No statistically significant differences in basic characteristics were observed in both groups of patients. The number of patients who had no pain (pain score=0) after MVA were significant increase in Ultracet group (P<0.01). In patients who still reported of pain, there was also lowered in pain intensity in Ultracet group. Only a few minor adverse effect was observed during the study. However this adverse effect showed no significant differences between groups.
Conclusion : We concluded that the addition of the preoperative administration of acetaminophen/tramadol confirmed its efficacy to prevent pain in patients who undergo MVA under a standard technique of paracervical block.

Keywords : ultracet, manual vacuum aspiration (MVA), pain score


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