Randomized controlled study on shortening the time of vaginal administration of carboprost methylate supposi-tory before surgical abortion and its effect on cervical ripening and perioperative safety
Objective To investigate whether shortening the time of vaginal administration of carboprost methylate(CM)suppository has effect on perioperative safety and cervical ripening in surgical abortion under general anesthesia.Methods This prospective clinical study included 120 patients undergoing surgical termination of first trimester preg-nancy and using CM for cervical preparation from November 2022 to Feberary 2023.Group A received CM at 1.5~2.0h before surgery;group B were given CM just before anesthesia.The average time of medication in both groups was(111.9±23.4)min and(21.5±10.6)min,respectively.The primary outcome was the cervical dilation time,and the sec-ondary outcomes included surgery completeness(surgery time,total bleeding and percentage of initial-passing 7.5 Hegar dilator),and perioperative adverse events(fever,abdominal pain,vomiting,nausea,desire to defecate,diarrhea).Results The dilation time of cervix and surgery completeness were similar between the two groups.However,CM-re-lated adverse events before anesthesia were significantly higher in group A than in group B(93.4%vs.28.8%,P<0.01),and the abdominal pain numerical rating scale(NRS)score was higher in group A[(2.8±2.1)vs.(0.3±0.5),P<0.01].The incidence of postoperative vomiting and nausea(PONV)was also significantly higher in group A(18.3%vs.6.7%,P=0.04).Conclusions Delayed vaginal administration of CM until before anesthesia is effective enough for cervical priming in surgical abortion and significantly re-duces adverse events.The findings of this study have im-portant clinical implications for improving patients'satis-faction and perioperative safety.