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[Comparative study of midazolam with ketamine S(+) versus midazolam with uterine paracervical block for manual intrauterine aspiration.].

BACKGROUND AND OBJECTIVES
The aim of this study was to evaluate the efficacy, postoperative analgesia, the degree of satisfaction of the patients submitted to manual intrauterine aspiration, and whether the patient would recommend the technique, by comparing two anesthetic techniques.


METHODS
A prospective study was done with 80 patients divided, randomized, in two groups. All of them received IV midazolam. Afterwards, the MC Group received IV Ketamaine S(+) and the MP Group underwent paracervical uterine block. In the operating room, the efficacy of the technique was evaluated by 3 observers (the researcher, the obstetrician, and the obstetrics resident) and, after one hour, an observer, who did not know which technique had been used, evaluated the postoperative analgesia, and the degree of satisfaction and whether or not the patient would recommend the technique, using a verbal scale.


RESULTS
The techniques were effective in 95% of the patients in the MC group and 76.7% of the patients in the MP group (p = 0.04). Among the patients in the MC group, 67% did not experience pain after 1 hour, while in the MP group the percentage of pain free patients was 33.3% (p < 0.01, and a relative risk = 2). Both groups had a 90% satisfaction rate and 90% would recommend the technique.


CONCLUSIONS
We concluded that anesthesia with midazolam and ketamine S(+) was better than the association of midazolam with uterine paracervical block for manual intrauterine aspiration, regarding both efficacy and postoperative analgesia. The index of satisfaction was very high for both techniques.