Adolescent Experiences with Procedural Sedation for Intrauterine Device Placement: A Pilot Study

Area of Science:

• Reproductive Health
• Adolescent Medicine
• Pain Management

Background:

• Intrauterine devices (IUDs) are highly effective reversible contraceptives and useful for menstrual management.
• Pelvic exams and insertion pain can deter IUD use among adolescents.
• Procedural sedation offers a potentially improved patient experience for IUD insertion.

Purpose of the Study:

• To examine adolescent experiences with intrauterine device (IUD) insertion utilizing conscious sedation.
• To assess patient satisfaction and recall following IUD insertion under different sedation types.

Main Methods:

• A prospective pilot study involving 16 adolescents aged 11-21 undergoing IUD insertion with conscious sedation.
• Participants completed pre- and post-procedure surveys on pain, experience, and satisfaction.
• Provider surveys documented sedation type, complications, and reasons for sedation.

Main Results:

• Most participants (14/16) received moderate sedation (midazolam/fentanyl); 2 received light sedation (nitrous oxide).
• The most cited "worst part" was procedural cramps (31%); the "best part" was sedation effects (44%).
• Patients reported high average satisfaction (83/100 VAS), with no significant difference between sedation types. Moderate sedation resulted in lower procedure recall (14% vs. 100%).

Conclusions:

• Adolescents express high satisfaction with conscious sedation during IUD insertion.
• Moderate sedation significantly reduces memory of the IUD insertion procedure compared to light sedation.
• Findings support the use of procedural sedation to improve adolescent IUD insertion experiences and inform clinical counseling.