2025 年 13 巻 3 号 p. 48-53
Aim: We introduced the use of paracervical block in combination with intravenous pentazocine and thiopental sodium for evacuation of first-trimester miscarriage or abortion, with the hypothesis that this regimen would reduce thiopental sodium dosage and its side effects compared with using intravenous anesthesia alone.
Methods: We retrospectively reviewed cases of singleton miscarriage or abortion before 12 weeks of gestation, classified into Group IV (intravenous anesthesia only) and Group IV+PB (intravenous anesthesia and paracervical block), from February 2019 to August 2022. The primary outcome was thiopental sodium dosage, and secondary outcomes were the need for prolonged hospitalization and incidence of nausea or vomiting.
Results: Seventy-six and 97 cases were included in Group IV and Group IV+PB, respectively. The amount of thiopental sodium was significantly lower in Group IV+PB (mean: 260±107 mg) than in Group IV (mean: 287±102 mg) (P=0.047). Regarding the need for prolonged hospitalization and incidence of nausea or vomiting, results were comparable between the two groups.
Conclusions: The combination of intravenous anesthesia and paracervical block effectively reduced the amount of anesthesia administered. This approach holds promise for enabling smoother pain relief, promoting early postoperative ambulation, and reducing side effects during evacuation procedures for first-trimester miscarriage or abortion.
