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Local anaesthesia for pain control in first-trimester surgical abortion: an updated Cochrane review

Cochrane Database Syst Rev doi/10.1002/14651858.CD006712

Abortions prior to 14 weeks' gestation are a common procedure and multiple methods have been trialled to improve pain control. This updated Cochrane review considers the latest randomised controlled trials (RCTs) on pain control in surgical abortions via suction evacuation up to 14 weeks. Thirteen studies with over 1900 participants were included and the outcomes included intraoperative pain, patient satisfaction and adverse events. The reivew concluded that 20 mL 1% lidocaine paracervical block decreases pain during the abortion procedure. This injection only needs to be 1.5 cm deep as opposed to 3 cm, and a two-point injection site has similar effectiveness to a four-point injection. There was inconsistent evidence on the use of topical cervical anaesthesia in pain control and so its routine use is not currently supported. Conscious sedation was not included in this review; however, the 2022 WHO guideline suggested a benefit and as such a combination of paracervical block, conscious sedation and nonsteroidal anti-inflammatory drugs should be offered to those undergoing surgical abortion up to 14 weeks's gestation to make this procedure more accessible and acceptable.

Self-sampling with oral rinse to detect oropharyngeal Neisseria gonorrhoeae among MSM: results from an exploratory study in Belgium (the SSONG Study)

Sex Transm Infect

Advances in self-collection and at-home collection sexually transmitted infection (STI) tests …

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  • Contributors Sole author of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.