HIỆU QUẢ GIẢM ĐAU CỦA THUỐC KHÁNG VIÊM KHÔNG STEROID TRONG GIẢM ĐAU DỰ PHÒNG VÀ GIẢM ĐAU THEO NHU CẦU KHI PHÁ THAI NỘI KHOA TẠI BỆNH VIỆN HÙNG VƯƠNG THÀNH PHỐ HỒ CHÍ MINH

Abstract

Background: Second-trimester medical abortion (13–22 weeks) is widely practiced in Vietnam. However, pain during the procedure remains a common concern, affecting patients’ experience and cooperation. While on-demand analgesia is commonly used, evidence on the effectiveness of preventive NSAID-based pain control in this setting is limited. Objective: To compare the effectiveness of preventive NSAID analgesia versus on-demand pain management in second-trimester medical abortion. Methods: A randomized controlled trial (RCT) was conducted at Hung Vuong Hospital from November 2024 to April 2025. A total of 180 eligible pregnant women were randomly assigned to either the preventive group (received Diclofenac 50 mg orally one hour before Misoprostol, repeated every 8 hours) or the on-demand group (received Diclofenac only upon request). Pain was assessed using the Visual Analog Scale (VAS) at five intervals and at the time of fetal expulsion. Abortion success rate and adverse effects were also recorded. Results: The mean pain score (VAS) was significantly lower in the preventive group compared to the on-demand group (4.60 ± 1.61 vs. 5.84 ± 1.73; p < 0.001). Statistically significant differences were observed at all assessment points. Both groups achieved high abortion success rates (>97%), with no significant differences in time to expulsion or blood loss. Conclusion: Preventive NSAID-based analgesia is effective and safe for pain control in second-trimester medical abortion. This strategy significantly reduces pain without compromising abortion outcomes and should be considered for routine clinical practice to improve patient-centered care.