Comparison of pain, cortisol levels, and psychological distress in women undergoing surgical termination of pregnancy under local anaesthesia versus intravenous sedation

<p>Abstract</p> <p>Background</p> <p>The weight of evidence suggests that women who freely choose to terminate a pregnancy are unlikely to experience significant mental health risks, however some studies have documented psychological distress in the form of posttraumatic stress disorder and depression in the aftermath of termination. Choice of anaesthetic has been suggested as a determinant of outcome. This study compared the effects of local anaesthesia and intravenous sedation, administered for elective surgical termination, on outcomes of pain, cortisol, and psychological distress.</p> <p>Methods</p> <p>155 women were recruited from a private abortion clinic and state hospital (mean age: 25.4 ± 6.1 years) and assessed on various symptom domains, using both clinician-administered interviews and self-report measures just prior to termination, immediately post-procedure, and at 1 month and 3 months post-procedure. Morning salivary cortisol assays were collected prior to anaesthesia and termination.</p> <p>Results</p> <p>The group who received local anaesthetic demonstrated higher baseline cortisol levels (mean = 4.7 vs 0.2), more dissociative symptoms immediately post-termination (mean = 14.7 vs 7.3), and higher levels of pain before (mean = 4.9 vs 3.0) and during the procedure (mean = 8.0 vs 4.4). However, in the longer-term (1 and 3 months), there were no significant differences in pain, psychological outcomes (PTSD, depression, self-esteem, state anxiety), or disability between the groups. More than 65% of the variance in PTSD symptoms at 3 months could be explained by baseline PTSD symptom severity and disability, and post-termination dissociative symptoms. Of interest was the finding that pre-procedural cortisol levels were positively correlated with PTSD symptoms at both 1 and 3 months.</p> <p>Conclusion</p> <p>High rates of PTSD characterise women who have undergone surgical abortions (almost one fifth of the sample meet criteria for PTSD), with women who receive local anaesthetic experiencing more severe acute reactions. The choice of anesthetic, however, does not appear to impact on longer-term psychiatric outcomes or functional status.</p

An unshielded radio-frequency atomic magnetometer with sub-femtoTesla sensitivity

We demonstrate a radio-frequency potassium-vapor magnetometer operating with sensitivities of 0.3 fT/ Hz at 0.5 MHz and 0.9 fT/ Hz at 1.31 MHz in the absence of radio-frequency and mu-metal or magnetic shielding. The use of spatially separated magnetometers, two voxels within the same cell, permits for the subtraction of common mode noise and the retention of a gradient signal, as from a local source. At 0.5 MHz the common mode noise was white and measured to be 3.4 fT/ Hz ; upon subtraction the noise returned to the values observed when the magnetometer was shielded. At 1.31 MHz, the common mode noise was from a nearby radio station and was reduced by a factor of 33 upon subtraction, limited only by the radio signal picked up by receiver electronics. Potential applications include in-the-field low-field magnetic resonance, such as the use of nuclear quadrupole resonance for the detection of explosives