Hydrocodone For Pain Control in First Trimester Surgical Abortion

NCT ID: NCT01330459

Last Updated: 2019-04-26

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

121 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-02-28

Study Completion Date

2011-10-31

Brief Summary

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The purpose of this study is to determine whether preoperatively administered hydrocodone/acetaminophen (HC/APAP) reduces pain during a first trimester surgical abortion.

Detailed Description

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The investigators plan to conduct a double-blinded randomized placebo-controlled trial of 120 women undergoing elective first trimester surgical abortion. These women will be premedicated with either two tabs of 5/350 hydrocodone/acetaminophen or 2 tabs of a placebo. All subjects will receive ibuprofen and lorazepam preoperatively and a PCB. This study will examine the incremental benefit of HC/APAP over this standard medication regimen. Randomization will be stratified into two groups. Subjects less than 8 weeks gestation will comprise the early gestational age group. Subjects between 8 weeks 0 days and 10 weeks 6 days will comprise the late gestational age group. The investigators will be assessing patient perception of pain, nausea, satisfaction, and anxiety at multiple points during the clinic visit using 100-mm visual analogue scales (VAS).

Conditions

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Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Hydrocodone/acetaminophen

Subject will receive hydrocodone/acetaminophen 45-90 minutes prior to abortion procedure.

Subject will also recieve ibuprofen, lorazepam, and lidocaine 45-90 minutes prior to abortion procedure.

Group Type ACTIVE_COMPARATOR

Hydrocodone/acetaminophen

Intervention Type DRUG

Administration of 2 tablets 5/325mg hydrocodone/acetaminophen 45-90 minutes prior to procedure.

Ibuprofen

Intervention Type DRUG

800 mg oral ibuprofen

Lorazepam

Intervention Type DRUG

2 mg oral lorazepam

Lidocaine

Intervention Type DRUG

20 ml 1% buffered lidocaine, injected

Placebo

Subject will receive placebo 45-90 minutes prior to abortion procedure.

Subject will also recieve ibuprofen, lorazepam, and lidocaine 45-90 minutes prior to abortion procedure.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Administration of 2 tablets methylcellulose (placebo) 45-90 minutes prior to procedure.

Ibuprofen

Intervention Type DRUG

800 mg oral ibuprofen

Lorazepam

Intervention Type DRUG

2 mg oral lorazepam

Lidocaine

Intervention Type DRUG

20 ml 1% buffered lidocaine, injected

Interventions

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Hydrocodone/acetaminophen

Administration of 2 tablets 5/325mg hydrocodone/acetaminophen 45-90 minutes prior to procedure.

Intervention Type DRUG

Placebo

Administration of 2 tablets methylcellulose (placebo) 45-90 minutes prior to procedure.

Intervention Type DRUG

Ibuprofen

800 mg oral ibuprofen

Intervention Type DRUG

Lorazepam

2 mg oral lorazepam

Intervention Type DRUG

Lidocaine

20 ml 1% buffered lidocaine, injected

Intervention Type DRUG

Other Intervention Names

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Vicodin

Eligibility Criteria

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Inclusion Criteria

* Aged 18 years or older
* Voluntarily requesting surgical pregnancy termination
* Pregnancy with intrauterine gestational sac up to 10 weeks 6 days gestation, dated by ultrasound
* Eligible for suction curettage
* English or Spanish speaking
* Good general health
* Able and willing to give informed consent and agree to terms of the study

Exclusion Criteria

* Gestational ages 11 weeks or more
* Incomplete abortion
* Premedication with misoprostol
* Use of any opioid medication within the past 7 days
* Use of heroin within the past 7 days
* Requested opioids or IV sedation prior to start of the procedure
* Patients who refuse ibuprofen or lorazepam
* Contraindications or allergies to HC/APAP, lidocaine, ibuprofen, or lorazepam
* Significant medical problem necessitating inpatient procedure
* Adnexal mass or tenderness on pelvic exam consistent with pelvic inflammatory disease
* Known hepatic disease
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Planned Parenthood Federation of America

OTHER

Sponsor Role collaborator

Elizabeth Micks

OTHER

Sponsor Role lead

Responsible Party

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Elizabeth Micks

Fellow in Family Planning

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Elizabeth Micks, MD

Role: PRINCIPAL_INVESTIGATOR

Oregon Health and Science University

Locations

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Planned Parenthood CW

Portland, Oregon, United States

Site Status

Oregon Health & Science University

Portland, Oregon, United States

Site Status

Countries

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United States

References

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Allen RH, Kumar D, Fitzmaurice G, Lifford KL, Goldberg AB. Pain management of first-trimester surgical abortion: effects of selection of local anesthesia with and without lorazepam or intravenous sedation. Contraception. 2006 Nov;74(5):407-13. doi: 10.1016/j.contraception.2006.06.002. Epub 2006 Aug 2.

Reference Type BACKGROUND
PMID: 17046383 (View on PubMed)

Belanger E, Melzack R, Lauzon P. Pain of first-trimester abortion: a study of psychosocial and medical predictors. Pain. 1989 Mar;36(3):339-350. doi: 10.1016/0304-3959(89)90094-8.

Reference Type BACKGROUND
PMID: 2710563 (View on PubMed)

Bone ME, Dowson S, Smith G. A comparison of nalbuphine with fentanyl for postoperative pain relief following termination of pregnancy under day care anaesthesia. Anaesthesia. 1988 Mar;43(3):194-7. doi: 10.1111/j.1365-2044.1988.tb05538.x.

Reference Type BACKGROUND
PMID: 3364636 (View on PubMed)

Dahl V, Fjellanger F, Raeder JC. No effect of preoperative paracetamol and codeine suppositories for pain after termination of pregnancies in general anaesthesia. Eur J Pain. 2000;4(2):211-5. doi: 10.1053/eujp.2000.0174.

Reference Type BACKGROUND
PMID: 10957701 (View on PubMed)

Edelman A, Nichols MD, Jensen J. Comparison of pain and time of procedures with two first-trimester abortion techniques performed by residents and faculty. Am J Obstet Gynecol. 2001 Jun;184(7):1564-7. doi: 10.1067/mob.2001.114858.

Reference Type BACKGROUND
PMID: 11408881 (View on PubMed)

Edelman A, Nichols MD, Leclair C, Astley S, Shy K, Jensen JT. Intrauterine lidocaine infusion for pain management in first-trimester abortions. Obstet Gynecol. 2004 Jun;103(6):1267-72. doi: 10.1097/01.AOG.0000127981.53911.0e.

Reference Type BACKGROUND
PMID: 15172863 (View on PubMed)

Edelman A, Nichols MD, Leclair C, Jensen JT. Four percent intrauterine lidocaine infusion for pain management in first-trimester abortions. Obstet Gynecol. 2006 Feb;107(2 Pt 1):269-75. doi: 10.1097/01.AOG.0000194204.71925.4a.

Reference Type BACKGROUND
PMID: 16449111 (View on PubMed)

Heath PJ, Ogg TW. Prophylactic analgesia for daycase termination of pregnancy. A double-blind study with controlled release dihydrocodeine. Anaesthesia. 1989 Dec;44(12):991-4. doi: 10.1111/j.1365-2044.1989.tb09206.x.

Reference Type BACKGROUND
PMID: 2619027 (View on PubMed)

Jensen MP, Chen C, Brugger AM. Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain. 2003 Sep;4(7):407-14. doi: 10.1016/s1526-5900(03)00716-8.

Reference Type BACKGROUND
PMID: 14622683 (View on PubMed)

Kan AS, Ng EH, Ho PC. The role and comparison of two techniques of paracervical block for pain relief during suction evacuation for first-trimester pregnancy termination. Contraception. 2004 Aug;70(2):159-63. doi: 10.1016/j.contraception.2004.03.013.

Reference Type BACKGROUND
PMID: 15288222 (View on PubMed)

Nichols, M. D., Halvorson-Boyd, G., Goldstein, R., Gevirtz, C., & Healow, D. (2009). Pain management. In M. Paul, E. S. Lichtenberg, L. Borgatta, D. A. Grimes & P. G. Stubblefield (Eds.), Management of unintended and abnormal pregnancy. (pp. 90-110): Wiley-Blackwell.

Reference Type BACKGROUND

O'Connell K, Jones HE, Simon M, Saporta V, Paul M, Lichtenberg ES; National Abortion Federation Members. First-trimester surgical abortion practices: a survey of National Abortion Federation members. Contraception. 2009 May;79(5):385-92. doi: 10.1016/j.contraception.2008.11.005. Epub 2008 Dec 11.

Reference Type BACKGROUND
PMID: 19341852 (View on PubMed)

Renner RM, Jensen JT, Nichols MD, Edelman A. Pain control in first trimester surgical abortion. Cochrane Database Syst Rev. 2009 Apr 15;2009(2):CD006712. doi: 10.1002/14651858.CD006712.pub2.

Reference Type BACKGROUND
PMID: 19370649 (View on PubMed)

Romero I, Turok D, Gilliam M. A randomized trial of tramadol versus ibuprofen as an adjunct to pain control during vacuum aspiration abortion. Contraception. 2008 Jan;77(1):56-9. doi: 10.1016/j.contraception.2007.09.008. Epub 2007 Nov 26.

Reference Type BACKGROUND
PMID: 18082668 (View on PubMed)

Rowbotham MC. What is a "clinically meaningful" reduction in pain? Pain. 2001 Nov;94(2):131-132. doi: 10.1016/S0304-3959(01)00371-2. No abstract available.

Reference Type BACKGROUND
PMID: 11690725 (View on PubMed)

Singh RH, Ghanem KG, Burke AE, Nichols MD, Rogers K, Blumenthal PD. Predictors and perception of pain in women undergoing first trimester surgical abortion. Contraception. 2008 Aug;78(2):155-61. doi: 10.1016/j.contraception.2008.03.011. Epub 2008 May 27.

Reference Type BACKGROUND
PMID: 18672118 (View on PubMed)

Suprapto K, Reed S. Naproxen sodium for pain relief in first-trimester abortion. Am J Obstet Gynecol. 1984 Dec 15;150(8):1000-1. doi: 10.1016/0002-9378(84)90399-5.

Reference Type BACKGROUND
PMID: 6507524 (View on PubMed)

Todd KH, Funk KG, Funk JP, Bonacci R. Clinical significance of reported changes in pain severity. Ann Emerg Med. 1996 Apr;27(4):485-9. doi: 10.1016/s0196-0644(96)70238-x.

Reference Type BACKGROUND
PMID: 8604867 (View on PubMed)

Uppington, J. (2006). Opioids. In J. Ballantyne (Ed.), Massachusetts General Hospital Handbook of Pain Management (pp. 106-126). Philadelphia: Lippincott Williams & Wilkins.

Reference Type BACKGROUND

Safe Abortion: Technical and Policy Guidance for Health Systems. 2nd edition. Geneva: World Health Organization; 2012. Available from http://www.ncbi.nlm.nih.gov/books/NBK138196/

Reference Type BACKGROUND
PMID: 23700650 (View on PubMed)

Wiebe E, Podhradsky L, Dijak V. The effect of lorazepam on pain and anxiety in abortion. Contraception. 2003 Mar;67(3):219-21. doi: 10.1016/s0010-7824(02)00516-4.

Reference Type BACKGROUND
PMID: 12618257 (View on PubMed)

Wiebe ER, Rawling M. Pain control in abortion. Int J Gynaecol Obstet. 1995 Jul;50(1):41-6. doi: 10.1016/0020-7292(95)02416-a.

Reference Type BACKGROUND
PMID: 7556858 (View on PubMed)

Micks EA, Edelman AB, Renner RM, Fu R, Lambert WE, Bednarek PH, Nichols MD, Beckley EH, Jensen JT. Hydrocodone-acetaminophen for pain control in first-trimester surgical abortion: a randomized controlled trial. Obstet Gynecol. 2012 Nov;120(5):1060-9. doi: 10.1097/aog.0b013e31826c32f0.

Reference Type DERIVED
PMID: 23090523 (View on PubMed)

Other Identifiers

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OHSU FAMPLAN 6734

Identifier Type: -

Identifier Source: org_study_id

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