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Clinical Summary

Opioids add no benefit for medical abortion-related pain

Takeaway

  • Oxycodone does not reduce pain in women undergoing medical abortion (MAB).

Key results

  • Overall, women reported their maximum reported pain level was a median of 8 out of 10.
  • No difference in reported pain levels between groups.
  • Participants reported a high peak pain level of 8/10 occurring 2.5-4 hours after misoprostol lasting for about 1 hour.
  • 50% of participants filled their prescriptions.
  • Only 15% used all prescribed pain medication; 85% of prescribed tablets were left unused.

Study design

  • Randomised, double-blind, placebo-controlled trial.
  • Patients undergoing MAB were recruited from 1 Planned Parenthood between 2017 and 2018 (n=172).
  • Participants were further stratified into groups by gestational age (<7 weeks vs 7-10 weeks).
  • Participants received ibuprofen (9 800-mg tabs plus placebo; n=86) vs ibuprofen (9 800-mg tabs) plus oxycodone (10 mg at onset of cramping and the paper prescription for 6 5-mg tabs; n=86).
  • Primary outcome was significantly lower maximum pain scores.
  • Data were collected through text message surveys.
  • Funding: Supported by the Society of Family Planning. 

 Limitations

  • Medications were prescribed and not dispensed; many prescriptions were unfilled.

References


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