A comparative study of pain levels use manual vacuum aspiration (MVA) in women with abnormal uterine bleeding during intravenous sedation and local anesthesia. Thatphanom Crown Prince Hospital.

Abstract

     This comparative research aimed to study and compare the pain level, satisfaction with pain management, and the effects of a manual vacuum aspirator (MVA) curettage in women with abnormal uterine bleeding (AUB) under intravenous anesthesia and local anesthesia at Thatphanom Crown Prince Hospital. The sample consisted of 50 women with abnormal uterine bleeding. They were divided into two groups, 25 women each, who met the specified criteria. Methods: Group A used proporfol with ketamine intravenous anesthesia, while Group B used local anesthesia around the cervix for 10-15 minutes before the MVA curettage. The research instruments included numerical pain rating scale (score 0-10) , A pain management satisfaction assessment form, and an impact data recording form. Data analysis: Descriptive statistics were analyzed using counts, percentages, means, and standard deviations. The average pain scores between groups were compared before and after participating in the activity using an independent t-test.

     The study results found that the pain assessment before the procedure in the group receiving intravenous anesthesia and the group using local anesthesia before the curettage using a vacuum aspirate (MVA) had an average pain score 2.36 and 2.72, respectively, at a slight level. After the procedure, the group receiving intravenous anesthesia had an average pain score 2.48, at a slight level. The group using local anesthesia had an average pain score 3.08, at a moderate level. Comparison between the groups revealed no statistical difference at the .05 level. As for satisfaction with the service system, location/equipment/tools, it was at the highest level, and in terms of personnel, it was at a high level in both groups. The effects occurred in the group using intravenous anesthesia, which was the most common at 48 percent, with a decrease in red blood cell concentration 4 percent, and a decrease in red blood cell concentration with a decrease in red blood cell concentration of 4 percent. The group using local anesthesia had a decrease in red blood cell concentration of 4 percent. In terms of hospitalization duration, the group using intravenous anesthesia was hospitalized for 1 day 84 percent and the group using local anesthesia 64 percent. The cost of vacuum aspiration (MVA) for the group using intravenous anesthesia cost an average of 8,000-12,000 baht, and the group using local anesthesia cost an average of 3,500-4,000 baht. Therefore, if there are no contraindications or limitations to treatment, the researcher recommends MVA treatment in women with abnormal uterine bleeding under local anesthesia, which will reduce the hospitalization time, have a lower chance of complications, and is twice as expensive as using intravenous anesthesia.