[Abortion induced by mifepristone and sulprostone combination: attempting analgesia with acetominophen or dipropyline]. / Interruptions volontaires de grossesse induites par l'association mifepristone-sulprostone: essai d'antalgie par le paracetamol ou la dipropyline.

PIP: 45 women undergoing 1st trimester abortions induced by RU-486 were divided into 3 groups for a double-blind randomized vs. placebo trail of analgesia following sulprostone administration. 600 mg of RU-486 was administered orally 36-48 hours before admission to the hospital. After admission, 10 women received 600 mg of acetaminophen, 14 received 80 mg of dipropyline, and 14 received a placebo. 500 mcg of sulprostone was injected about 30 minutes later. The study excluded method failures, expulsions occurring before hospital admission, deviations from the protocol, and delays to expulsion greater than 8 hours. There was no significant difference between the 3 groups in maximal pain, but the placebo group appeared to experience less discomfort than the other two. The delay to expulsion was significantly longer in the acetaminophen group than in the other two. The relatively lower amount of pain in the placebo group was probably due to the reduced proportion of nulliparas in it compared to the other 2 groups. 6 women in the acetaminophen group, 9 in the dipropyline group, and only 5 in the placebo group were nulliparas. Comparing nulliparas with mothers within groups, the maximal pain was significantly less intense among mothers than among nulliparas in the placebo group and to a lesser extent in the dipropyline group but not in the acetaminophen group. Based on these results it is recommended that a systematic study be made of analgesia for RU-486 and sulprostone-induced abortions. An antispasmodic effect on the cervical fibers should be sought more than analgesia per se.^ieng