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An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
14:56

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Published on: January 27, 2010

Interventions for pain with intrauterine device insertion.

Rebecca H Allen1, Deborah Bartz, David A Grimes

  • 1Department of Obstetrics and Gynecology, Women and Infants' Hospital, 101 Dudley Street, Providence, Rhode Island, 02905, USA.

The Cochrane Database of Systematic Reviews
|July 10, 2009
PubMed
Summary

Pain during intrauterine device (IUD) insertion is a significant concern. Current evidence suggests no properly evaluated interventions effectively reduce IUD insertion pain, though topical lidocaine shows promise.

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Area of Science:

  • Reproductive Health
  • Contraception
  • Pain Management

Background:

  • Fear of pain during intrauterine device (IUD) insertion is a major barrier to its use.
  • Common interventions include NSAIDs, local anesthetics, and cervical ripening agents like misoprostol.

Purpose of the Study:

  • To systematically review all randomized controlled trials (RCTs) evaluating treatments for pain associated with IUD insertion.

Main Methods:

  • Searched multiple databases (MEDLINE, POPLINE, CENTRAL, EMBASE) and reference lists for relevant RCTs.
  • Included RCTs in any language comparing interventions to placebo or active treatments.
  • Data abstracted independently and analyzed using RevMan 5.0, calculating odds ratios and mean differences.

Main Results:

  • Four trials with 2204 participants were included. NSAIDs were ineffective for reducing pain during IUD insertion.
  • Misoprostol did not reduce insertion pain in nulliparous women. One trial suggested naproxen may reduce post-insertion pain, but used an outdated IUD.
  • Another trial found ibuprofen ineffective for post-insertion pain relief.

Conclusions:

  • No interventions have been adequately proven to reduce pain during or after IUD insertion.
  • A single, less controlled study indicated topical lidocaine gel might alleviate insertion pain, warranting further research.