在IUD插入之日评估利多卡因和阿片类药物管理的变化,2018-2025年
Nina B Masters1, Karen Gilbert Farrar1, Brianna M Goodwin Cartwright1
1Truveta, Inc. Bellevue Washington.
Contraception
|December 14, 2025
概括
尽管有新的CDC指导方针,但对于宫内器件 (IUD) 插入的疼痛管理仍然不常见. 在2025年,95%的患者在插入IUD时没有接受利多卡因或阿片类药物,这表明需要改进疼痛控制策略.
科学领域:
- 生殖健康 生殖健康
- 避孕药是一种避孕药,用于避孕.
- 疼痛管理 疼痛管理
背景情况:
- 宫内避孕器 (IUD) 是一种高效的长效可逆避孕药.
- 插入宫内节育器通常与严重的疼痛有关.
- 疾病控制和预防中心 (CDC) 在2024年8月更新了关于IUD插入期间疼痛管理的指南.
研究的目的:
- 分析在IUD插入之日使用利多卡因和阿片类药物治疗疼痛的现实趋势.
- 评估2024年CDC建议对止痛药使用的影响.
- 评估IUD插入期间疼痛管理的流行情况.
主要方法:
- 使用了Truveta Data的一个子集,Truveta Data是一个电子健康记录数据库.
- 捕获的利多卡因和阿片类药物在IUD插入之日订购或使用.
- 采用物流中断时间序列模型来分析预测因素和指南影响.
主要成果:
- 从2018年1月到2025年6月,分析了286144个宫内节育器插入.
- 止痛药的使用量从2018年的1.7%增加到2025年的5.0%.
- 疾病预防控制中心的指导方针显示,利多卡因的几率增加了18% (aOR 1.18) 和阿片类药物的几率增加了22% (aOR 1.22),但月度趋势没有改变.
结论:
- 尽管利多卡因和阿片类药物使用指南后的统计显著增加,但95%的IUD接受者在2025年没有得到疼痛控制.
- 对利多卡因和阿片类药物使用的低估可能是由于依赖结构化计费和药物领域,在临床笔记中可能缺少数据.
- 尽管更新了临床建议,但IUD插入期间的疼痛管理仍然未得到充分利用.
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