Analgesic effects of acetaminophen, diclofenac and hyoscine N-butylbromide in second trimester pregnancy termination: a prospective randomized study

J Matern Fetal Neonatal Med. 2016 Dec;29(23):3838-42. doi: 10.3109/14767058.2016.1148134. Epub 2016 Mar 3.


Objectives: This prospective, randomized study aimed to compare the analgesic effects of acetaminophen, diclofenac and hyoscine-N-butylbromide (HnBB) in cases of second trimester pregnancy termination.

Methods: In 60 women with indications for second trimester pregnancy termination, three analgesic agents were randomized into three groups: group 1, acetaminophen; group 2, diclofenac; and group 3, HnBB. A visual analog scale (VAS) used for the evaluation of pain perception. The primary outcome of the study was mean VAS score during the procedure and last VAS score before the completion of termination. The secondary outcomes were the induction-to-abortion interval, the percentage of aborted cases within the first 24 h and finally the need for parenteral analgesia.

Results: Demographic characteristics were similar among the groups. The mean VAS and last VAS scores before termination did not differ among the groups (p = 0.3 and 0.2, respectively). The need for parenteral analgesia did not differ among the groups (p = 0.3). Although a shorter induction-to-abortion interval and greater number of cases with successful termination before 24 h were found in the HnBB group, the differences were not statistically significant (p = 0.6 and 0.5, respectively).

Conclusions: Our study did not demonstrate a difference in pain perception among second trimester pregnancy termination cases using acetaminophen, diclofenac and HnBB.

Keywords: Induction to abortion interval; medical abortion; misoprostol; oral analgesics; visual analog score.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Abortion, Induced / methods*
  • Acetaminophen / therapeutic use*
  • Adult
  • Analgesics, Non-Narcotic / therapeutic use*
  • Analysis of Variance
  • Butylscopolammonium Bromide / therapeutic use*
  • Diclofenac / therapeutic use*
  • Female
  • Humans
  • Pain Measurement*
  • Pregnancy
  • Pregnancy Trimester, Second
  • Prospective Studies
  • Young Adult


  • Analgesics, Non-Narcotic
  • Diclofenac
  • Butylscopolammonium Bromide
  • Acetaminophen