SUMMARY POINTS

Pain perception includes both physical and psychosocial elements, and is best managed with both non-pharmacological and pharmacological techniques.
Paracervical block helps reduce pain, and there are many variations on technique.
Oral medications such as NSAIDs, opioids or anxiolytics may be used individually or together during uterine aspiration.
Intravenous pain management may be chosen if monitoring and staffing are available; patients may require provision of respiratory support.
Deep sedation (a.k.a. general anesthesia) is used, but is not routinely recommended (Ipas 2016).

Universal pre-procedure antibiotic prophylaxis for uterine aspiration is well supported by the available evidence.
Attention to allergies, concurrent medications, conditions that compromise respiratory status, recommended dose limits, and antidotes will improve safety.
The supplies in your emergency cart should be reviewed, along with procedures and regular simulations for emergency management.

In addition to pain medications, utilize gentle procedural technique, deep-breathing techniques, distraction through conversation, the support of a partner, friend, doula, or medical assistant, and the reassuring tone of your voice.

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