Paracervical Block With Combined Ketorolac and Lidocaine for Osmotic Dilator Placement

Inclusion Criteria: * Age of at least 18 years * English or Spanish speaking * Ability and willingness to sign the informed consent * Ability and willingness to comply with the terms of the study including possessing active cell phone with text messaging capabilities * Voluntary request for pregnancy termination * Ultrasound-confirmed singleton intrauterine pregnancy with an estimated gestational age of 16+0-24+6 weeks gestational age * Require osmotic dilator placement one day prior to procedural abortion according to institutional protocol * Seeking outpatient abortion services at Rush University Medical Center Exclusion Criteria: * Have taken NSAIDs less than 6 hours prior to their clinic visit * Contraindications to lidocaine such as allergy to lidocaine, cardiac arrhythmia or heart block, and porphyria * Allergic reaction or sensitivity to NSAIDs * History of peptic ulcer or gastrointestinal bleed, history of gastric bypass (RYGB) or recent history in last 6 months of gastric sleeve; history of inflammatory bowel disease (Ulcerative colitis, Crohn's disease) * Uncontrolled hypertension, heart failure, ischemic heart disease, peripheral arterial disease, cerebrovascular disease * Acute renal failure or chronic renal disease * Chronic liver disease * History of bleeding diathesis * Untreated acute cervicitis or pelvic inflammatory disease * Require or request IV sedation for placement of osmotic dilators * Require more than 1 day of osmotic dilators * Chronic or current…