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Objective
To determine the efficacy of pre-emptive administration of the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen vs. a placebo on pain relief during medical abortion and to evaluate whether NSAIDs interfere with the action of misoprostol.
Design
Prospective, double-blind, randomized, controlled study.
Setting
University-affiliated tertiary hospital.
Patient(s)
Sixty-one women who underwent first-trimester termination of pregnancy.
Intervention(s)
Patients received 600 mg mifepristone orally, followed by 400 ¦Ìg oral misoprostol 2 days later. They were randomized to receive pre-emptively two tablets of 400 mg ibuprofen orally or a placebo, when taking the misoprostol. The patients completed a questionnaire about side effects and pain score and returned for an ultrasound follow-up examination 10-14 days after the medical abortion.
Main Outcome Measure(s)
Significant pain, assessed by the need for additional analgesia, and failure rates, defined by a need for surgical intervention.
Result(s)
Pre-emptive ibuprofen treatment was found to be more effective than a placebo in pain prevention, as determined by a significantly lower need for additional analgesia: 11 of 29 (38 % ) vs. 25 of 32 (78 % ), respectively. Treatment failure rate was not statistically different between the ibuprofen and placebo groups: 4 of 28 (14.2 % ) vs. 3 of 31 (9.7 % ), respectively. History of menstrual pain was predictive for the need of additional analgesia.
Conclusion(s)
Pre-emptive use of ibuprofen had a statistically significant beneficial effect on the need for pain relief during a mifepristone and misoprostol regimen for medical abortion. Ibuprofen did not adversely affect the outcome of medical abortion.
Clinical Trial Registration Number
NCT00997074.
