The goal of this study was to see if high-frequency, high-intensity transcutaneous electrical nerve stimulation (TENS) might be used as a low-cost, noninvasive pain management method for first-trimester aspiration abortion. TENS or intravenous (IV) sedation were administered to participants. The primary outcome was aspiration pain as self-reported by visual analogue scale. A total of 90 participants were required to detect at least a 15 mm mean difference on the 100 mm VAS with 90% power and a significance level of.05. The study registered 109 people between January 2018 and October 2019. The median gestation of participants in the TENS group was 53 days and 58 days in the IV group. For the primary outcome, the intention-to-treat analysis produced noninferior results. In the per-protocol analysis, 9 people in the TENS group were removed after receiving IV sedation; 100 participants and 66 individuals in the TENS and IV groups, respectively, were included. TENS was shown to be noninferior to IV with a mean difference of 4.4 mm. Physicians miscalculated participant pain, estimating it to be 34 mm in the TENS group and 25 mm in the IV group.
TENS was a noninferior treatment to IV sedative for aspiration pain during a first-trimester abortion. Extending pain treatment alternatives may enhance the quality and accessibility of abortion. Transcutaneous electrical nerve stimulation may be a standalone or supplemental method for abortion pain management for people who do not have access to or are ineligible for IV sedation owing to a lack of a sedation practitioner, designated driver, or local limitations.
