***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Forty-four patients presenting for evacuation of retained products of conception were anaesthetized with either fentanyl and thiopentone , or alfentanil with etomi date , along with 70 % nitrous oxide in oxygen . There was no difference between the two techniques in indices of immediate recovery ( time to opening eyes and obeying a simple comm and ) , but the rate of return of higher mental functions ( assessed by a coin counting test ) was significantly better using the alfentanil-etomi date technique . There was no statistically significant difference between the techniques for apnoea or abnormal movements during anaesthesia , but alfentanil with etomi date was associated with significantly more pain on injection and a higher frequency of postoperative vomiting ( 40 % ) OBJECTIVE To evaluate pain relief using paracervical nerve block with 1 % lignocaine injection in patients undergoing uterine evacuation by Manual Vacuum Aspiration ( MVA ) for the treatment of incomplete abortion . DESIGN A r and omized double blind clinical trial . SETTING Marie Stopes Health Centre , Nairobi . METHODS One hundred and forty two patients were recruited between September and October 1997 . The intervention was r and om assignment to the study group ( paracervical block with 1 % lignocaine ) or the placebo group ( paracervical block with sterile water for injection ) . Intra and post operative assessment of pain was made using McGills and facial expression scales . RESULTS The untreated group experienced significantly more pain than the treated group , especially lower abdominal pain and backache . The pain was especially marked intraoperatively , less so 30 minutes post-operatively . CONCLUSION Based on the findings of this study , any patient going for manual vacuum aspiration for the treatment of incomplete abortion should be given Paracervical block as it is cost effective , easy to perform and with less side effects One hundred and fifteen patients admitted to Duke University Medical Center from January 1 , 1973 , to December 31 , 1974 inclusive , with the diagnosis of uncomplicated spontaneous incomplete or inevitable abortion were included in a r and omized prospect i ve study . All patients underwent suction curettage under either analgesia or general inhalation anesthesia . Patient response was adjudged regarding comfort and cooperativeness in the group receiving analgesia and postprocedure rehabilitation and discharge times in both groups . Fifteen of 59 patients receiving analgesia only were recorded unanimously as failures . Post-operative ambulation was no more rapid in patients receiving analgesia . Procedure-to-discharge intervals were unrelated to medication modality . There appears to be no advantage to analgesia as far as rehabilitation time , procedure-to-discharge time , and medical complications are concerned Background and objective : This study was design ed to determine which single bolus dose of remifentanil in combination with propofol and nitrous oxide is best to control the haemodynamic , autonomous and somatic responses in patients scheduled for dilatation and curettage of the uterine cervix . We evaluated the adequacy of different bolus doses of remifentanil , associated with propofol and nitrous oxide , for dilatation and curettage in a prospect i ve double-blind study . Methods : After institutional approval and informed consent , 34 healthy females undergoing curettage to remove material from the uterus after spontaneous abortion were r and omized to receive remifentanil 0.5 μg kg−1 intravenously ( i.v . ) ( Group A ; n = 4 ) , 1 μg kg−1 i.v . ( Group B ; n = 15 ) or 1.5 μg kg−1 i.v . ( Group C ; n = 15 ) , with propofol 2 mg kg−1 i.v . in all groups . Anaesthesia was maintained with 60 % nitrous oxide in oxygen . Haemodynamic , somatic and autonomic signs of light anaesthesia were registered to assess the response to surgical stress . Recovery times and Aldrete score were recorded at the end of the procedure . Results : The groups were similar with regard to biometric data and duration of surgery . The poor results using the lowest dose of remifentanil obliged us to ab and on this dose . The total dose of remifentanil was larger in Group C ( 100 ± 5.7 μg vs. 65 ± 4.1 μg in Group B ; P < 0.05 ) , but more patients required extra bolus injections in Group B ( 69 % vs. 38 % in Group C ; P < 0.01 ) . Recovery times were significantly shorter in Group C. Aldrete scores when leaving the operation room was similar . Conclusions : Remifentanil 1.5 μg kg−1 i.v . with propofol 2 mg kg−1 i.v . and 60 % nitrous oxide in oxygen provided the best anaesthetic control with the fastest recovery times OBJECTIVE To estimate the effectiveness of different methods of analgesia among women treated with manual vacuum aspiration for spontaneous abortion . MATERIAL S AND METHODS The 113 patients diagnosed with incomplete abortion and considered c and i date s for manual vacuum aspiration were r and omly assigned to 3 groups of analgesic administration : diclofenac plus paracervical block ; meperidine plus diclofenac ; and meperidine alone .  Pain levels were evaluated using the Wong Scale of Pain . RESULTS The mean pain scores for the three groups were : diclofenac and paracervical block 5.4 ; meperidine plus diclofenac 5.0 ; meperidine 5.7 ( P=0.57 ) . Analysis of pain using the levels mild ( 0 - 3 ) , moderate ( 4 - 6 ) , and severe ( 7 - 10 ) showed no statistical significance among the 3 groups of analgesics . Adverse effects were more common in the groups using analgesia containing meperidine . CONCLUSIONS There was no significant difference between the analgesics used among the 3 groups . Most of the patients , regardless of the analgesic used , reported moderate pain OBJECTIVE To compare evacuation under systemic analgesia ( fentanyl and midazolam ) in a treatment room ( ward group ) with evacuation under general anaesthesia in theatre . DESIGN A prospect i ve r and omised clinical trial . SETTING A tertiary medical centre serving a black urban population . SUBJECTS One hundred and forty-two patients with uncomplicated incomplete abortions . INTERVENTION R and omisation into two groups , those for evacuation under systemic analgesia and those for evacuation under general anaesthesia . MAIN OUTCOME MEASURES Both groups were compared in terms of safety , efficacy , acceptability , blood consumption and time delay between admission and evacuation . RESULTS Significantly less blood was used in the ward group ( 37 units for 13 patients ) than in the theatre group ( 65 units for 24 patients ) ( P < 0.03 ) . Significantly less time was taken between admission and evacuation in the ward group ( median 7 hours 15 minutes ) than in the theatre group ( median 12 hours 38 minutes ) ( P < 0.0003 ) . Evacuation under fentanyl and midazolam was safe , effective and acceptable for the majority of patients compared with evacuation under general anaesthesia . CONCLUSION Patients with uncomplicated incomplete abortions ( uterine size equivalent to a pregnancy of 14 weeks ' duration or less ) can undergo evacuation safely and effectively under fentanyl and midazolam and have a significantly smaller chance of requiring a blood transfusion 
    Output:
    
In terms of postoperative pain , PCB does not improve the control of postoperative pain when it is compared against sedation/analgesia or versus no anaesthesia/no analgesia .