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Effect of General and Local Anaesthesia on Blood Loss During and after Therapeutic Abortion

Abstract. The blood loss occurring during therapeutic abortion performed under local and general anaesthesia and the postoperative bleeding was measured in 60 healthy women in the first trimester of pregnancy. The patients were 20‐30 years old (mean age 24.3 years), all being nulliparae. They were divided into three equal groups according to the duration of pregnancy. In each group, 10 patients underwent abortion under general anaesthesia, and the remaining 10 under local anaesthesia. In all cases, cervical dilatation by the Hegar method and vacuum aspiration were used, and all operations were performed by the same surgeon. General anaesthesia was induced with atropine and thiopental and maintained with inhalation of a 2:1 mixture of nitrous oxide and oxygen and small doses of thiopental and pethidine. Local anaesthesia consisted in paracervical blockade produced by injection of 1 % lidocaine‐adrenaline. The blood loss (Table I) was smallest in the 7th and 8th weeks of pregnancy under both local and general anaesthesia and increased with the gestational age. In all three groups, the blood loss during operation under general anaesthesia was nearly twice as large as under local anaesthesia. There was no difference in the postoperative bleeding under local and general anaesthesia. It is concluded that local anaesthesia has several advantages. Paracervical blockade provides a rapid and reliable anaesthesia which is adequate for most patients. The costs, delays and complications of general anaesthesia are avoided. Local anaesthesia is well suited for out‐patients, and the blood loss is reduced to a minimum.