TY - JOUR
T1 - An Evaluation of Oral Midazolam for Anxiety and Pain in First-Trimester Surgical Abortion
T2 - A Randomized Controlled Trial
AU - Bayer, Lisa L.
AU - Edelman, Alison B.
AU - Fu, Rongwei
AU - Lambert, William
AU - Nichols, Mark D.
AU - Bednarek, Paula H.
AU - Miller, Kelsey
AU - Jensen, Jeffrey T.
N1 - Publisher Copyright:
© 2015 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015/7/23
Y1 - 2015/7/23
N2 - Objective: To estimate the effect of oral midazolam on patient pain and anxiety perception during first-trimester surgical abortion. Methods: Between May and December 2013, we conducted a randomized, double-blind, placebo-controlled trial. Patients between 6 0/7 and 10 6/7 weeks of gestation received 10 mg oral midazolam or placebo 30-60 minutes before surgical abortion. All patients received ibuprofen and a paracervical block. We powered the study (power80%; significance level.025) to detect a 15-mm difference in our two a priori primary outcomes of pain and anxiety with uterine aspiration on a 100-mm visual analog scale. Secondary outcomes were pain and anxiety at additional time points, memory, satisfaction, side effects, and adverse events. Results: Demographics were similar between groups (placebo62, midazolam62). Compared with those randomized to placebo, patients who received midazolam had significantly less anxiety preoperatively (room entry: 51.4 mm compared with 34.5 mm, P<.001; positioning: 56.6 mm compared with 45.4 mm, P.02). There was no difference in pain (P.28) or anxiety (P.14) during uterine aspiration or at other procedural time points. A significantly greater number of patients in the midazolam group reported partial amnesia (31/61 compared with 16/61, P.005) and dizziness (30/61 compared with 18/61, P.03). Controlling for baseline differences, patients who received midazolam reported more postoperative sleepiness (P<.001) and less postoperative nausea (P.004). There was no difference in overall satisfaction (P.88). Conclusion: Although oral midazolam reduces preprocedural anxiety, it does not reduce pain or anxiety with uterine aspiration during first-trimester surgical abortions.
AB - Objective: To estimate the effect of oral midazolam on patient pain and anxiety perception during first-trimester surgical abortion. Methods: Between May and December 2013, we conducted a randomized, double-blind, placebo-controlled trial. Patients between 6 0/7 and 10 6/7 weeks of gestation received 10 mg oral midazolam or placebo 30-60 minutes before surgical abortion. All patients received ibuprofen and a paracervical block. We powered the study (power80%; significance level.025) to detect a 15-mm difference in our two a priori primary outcomes of pain and anxiety with uterine aspiration on a 100-mm visual analog scale. Secondary outcomes were pain and anxiety at additional time points, memory, satisfaction, side effects, and adverse events. Results: Demographics were similar between groups (placebo62, midazolam62). Compared with those randomized to placebo, patients who received midazolam had significantly less anxiety preoperatively (room entry: 51.4 mm compared with 34.5 mm, P<.001; positioning: 56.6 mm compared with 45.4 mm, P.02). There was no difference in pain (P.28) or anxiety (P.14) during uterine aspiration or at other procedural time points. A significantly greater number of patients in the midazolam group reported partial amnesia (31/61 compared with 16/61, P.005) and dizziness (30/61 compared with 18/61, P.03). Controlling for baseline differences, patients who received midazolam reported more postoperative sleepiness (P<.001) and less postoperative nausea (P.004). There was no difference in overall satisfaction (P.88). Conclusion: Although oral midazolam reduces preprocedural anxiety, it does not reduce pain or anxiety with uterine aspiration during first-trimester surgical abortions.
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U2 - 10.1097/AOG.0000000000000913
DO - 10.1097/AOG.0000000000000913
M3 - Article
C2 - 26241254
AN - SCOPUS:84932135570
SN - 0029-7844
VL - 126
SP - 37
EP - 46
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 1
ER -