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Saturday, August 17, 2013

Trailers (56): Ibuprofen for analgesia in first trimester medical abortion

Raymond et al. Prophylactic compared with therapeutic ibuprofen analgesia in first trimester medical abortion: a randomized controlled trial

Why should you read about this topic?

Because pain control is one of the most important objectives of our role as health care provider

What were the authors trying to do?

To compare two regimens for oral analgesia in the context of medical abortion

Who participated and in what setting?

Women (N= 228) undergoing medical abortion at <9 weeks at clinics in New York and Chicago between 2011-2

What was the study design?

Randomized controlled trial of prophylactic or therapeutic ibuprofen

What were the main outcome measures?

Maximum pain scores

What were the results?

Mean maximum pain score (0-10) was 7.1 for prophylactic and 7.3 for therapeutic regimens.  No difference between groups.

What is the most interesting image in the paper?

Figure 3

What were the study strengths and weaknesses?

Strengths: randomized, controlled trial; acceptable treatment assignment adherence rate; excellent participant retention rate. Weaknesses: treatment compliance rate not assessed.

What does the study contribute for your practice?

Whether ibuprofen is taken therapeutically or prophylactically makes no difference:  both are equally bad for pain control during first trimester medical abortion.