Please select the eligibility criteria that correspond to the clinical trial below.
Title: Transcutaneous Electrical Nerve Stimulation (TENS) for Pain Control During First Trimester Abortion: A Blinded Randomized Controlled Trial
Brief Summary: High-frequency, high-intensity transcutaneous electrical nerve-stimulation (TENS) is an inexpensive and non-invasive pain control approach. TENS, pulsating electrical currents that activate underlying nerves, does not have drug interactions or risk of overdose. Cochrane review of TENS for acute pain found inconclusive evidence. One previous abortion trial comparing TENS to IV sedation only looked at pain control in the recovery room. The investigators propose a randomized controlled trial comparing TENS to IV sedation (in conjunction with local anesthesia) among women presenting for first-trimester surgical abortion. Primary outcome will be perceived pain by Visual Analogue Scale (VAS) during aspiration.


Options:
A: Inclusion Criteria:

* age greater than or equal to 18 years
* English-speaking
* ability and willingness to sign the informed consent
* ability and willingness to comply with the terms of the study
* voluntary request for pregnancy termination
* ultrasound-confirmed singleton intrauterine pregnancy with an estimated gestational age not exceeding 76 days (10 6/7 weeks) from the first day of the preceding menstrual cycle

Exclusion Criteria:

* women who require or request sedation
* untreated acute cervicitis or pelvic inflammatory disease
* contraindications to lidocaine such as allergy to lidocaine, cardiac arrhythmia or heart block, and porphyria
* allergic reaction or sensitivity to lorazepam or NSAIDs
* chronic NSAID use
* history of gastritis or gastric ulcer
* acute renal failure or chronic renal disease
* chronic liver disease
* history of bleeding diathesis
* chronic narcotic use
* current or past history of illegal drug use (excluding marijuana)
B: Inclusion criteria:

* Presenting for surgical abortion
* Gestational age \<12 weeks
* \< 18 years of age
* Agrees to be randomized

Exclusion criteria:

* Allergy to study medications (lidocaine, fentanyl, midazolam)
* \> 18 years of age
* Fetal demise
* Pre-procedure use of misoprostol
* No means of transportation following procedure
C: Inclusion criteria:

* Women ages 18 and older undergoing elective surgical abortion at 5 and 0/7 to 11 and 6/7 weeks gestational age
* Use of IV sedation for pain management
* English or Spanish speaking
* Ability to give informed consent

Exclusion criteria:

* Any pre-operative use of misoprostol (typically given at 12 weeks and above in this clinic)
* Allergy to study medications: lidocaine, midazolam, fentanyl
* Known uterine anomaly
* Prior cervical surgery.
D: Inclusion Criteria:

* Age 18 or older.
* Undesired pregnancy between 6 0/7-12 6/7 weeks gestation.
* Has already signed consent for pregnancy termination.
* Eligible for IV sedation per clinic protocol.

Exclusion Criteria:

* Under 120 lbs.
* Allergies to any of the drugs being studied.
* Chronic narcotics, barbiturates or benzodiazepine use within the past year.
* History of IV drug use within the last year.
* Inability to give informed consent.
* Does not speak English or Spanish and does not have translator for all study procedures
* Previously participated in study

Answer: B