Retrospective Evaluation of the Procedural Sedation Practices of Expert Nurses During Abortion Care

J Obstet Gynecol Neonatal Nurs. Sep-Oct 2017;46(5):755-763. doi: 10.1016/j.jogn.2017.06.003. Epub 2017 Jul 17.

Abstract

Objective: To evaluate the provision of procedural sedation during abortion by expert nurses and to describe the factors that are associated with time to discharge for women who receive this sedation.

Design: Retrospective chart review.

Methods: Descriptive statistics were generated to describe a retrospective cohort of women presenting for abortion under procedural sedation. Analysis of variance was used to determine significant characteristics that influenced time to discharge.

Setting: A single clinical site that employs seven expert nurses.

Participants: A total of 194 medical records were available for this analysis.

Results: All women were discharged home with accompaniment, and no incidents of respiratory distress or other adverse complications occurred. Most women (n = 136) received at least 150 μg fentanyl and 3 mg midazolam, and 71% of women in the first trimester and 83% of women in the second trimester entered the recovery area with no pain. Variables significantly associated with time spent in the recovery area were gestational age at time of abortion (t = -2.68, p = .008), pain at entry to recovery area (t = -0.254, p = .008), and pain at 15 minutes (t = 0.25, p = .038).

Conclusion: Expert nurses can administer procedural sedation for pain control associated with abortion and are capable of monitoring women and helping them return to baseline status after the procedure.

Keywords: abortion; procedural sedation; time to discharge.

MeSH terms

  • Abortion, Legal* / adverse effects
  • Abortion, Legal* / methods
  • Abortion, Legal* / nursing
  • Adult
  • Anesthetics, Intravenous / administration & dosage
  • Anesthetics, Intravenous / adverse effects
  • Conscious Sedation* / methods
  • Conscious Sedation* / nursing
  • Female
  • Fentanyl* / administration & dosage
  • Fentanyl* / adverse effects
  • Humans
  • Midazolam* / administration & dosage
  • Midazolam* / adverse effects
  • Outcome and Process Assessment, Health Care
  • Pain Management / methods
  • Pain Measurement / methods
  • Pain, Procedural* / diagnosis
  • Pain, Procedural* / therapy
  • Pregnancy
  • Retrospective Studies

Substances

  • Anesthetics, Intravenous
  • Midazolam
  • Fentanyl