Interventions for pain with intrauterine device insertion

Lopez, Laureen M; Bernholc, Alissa; Zeng, Yanwu; Allen, Rebecca H.; Bartz, Deborah; O’Brien, P. T.; Hubacher, David

doi:10.1002/14651858.cd007373.pub3

Cited by 93 publications

(112 citation statements)

References 64 publications

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“…20 It was observed that tramadol and naproxenin mitigated pain in some specific groups. 21 It was shown that use of topical lidocaine 2% gel did not have any effect on the pain scores after tenaculum placement, application and procedure in IUD insertion.…”

Section: Discussionmentioning

confidence: 99%

Intrauterine levobupivacaine for pain control during intrauterine device insertion

Akgün

Keskin

Kalem

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Safe, effective, long term and a reversible contraception method is offered by intrauterine devices (IUDs). The objective was to determine the potency of intrauterine administration of 5 cc levobupivacain for pain relief with IUD insertion, when compared with saline placebo.Methods: This was a prospective randomized, double blind placebo-controlled trial undergoing İUD insertion. The trial medication was intrauterine anesthesia, either 5 mL 0.9% saline (control group), or 5 mL 0.5% levobupivacaine. Our primary outcome was self-reported pain scores on a 10 cm visual analogue scale (VAS) immediately following IUD insertion.Results: 95 women were enrolled, and data for 88 women were analyzed. In IUD insertion procedure, no difference was observed between groups during teneculum placement and solution administration, in the course of VAS scores (p=0.349, p=0.396). There was a significant difference in the VAS scores measuring pain suffering during and after IUD procedure (p=0.001).Conclusions: Intrauterine instillation of 5 cc of levobupivacaine along with saline solution reduces pain with IUD insertion when compared to intrauterine saline placebo. Broad deviation in pain scores and persistent pain after IUD insertion recommends that patient would benefit from more functioning method of pain control than before at IUD insertion and during the post interval.

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Section: Discussionmentioning

confidence: 99%

Intrauterine levobupivacaine for pain control during intrauterine device insertion

Akgün

Keskin

Kalem

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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show abstract

“…Intrauterine devices (IUD) are a highly effective, reliable, and safe form of contraception [1]. The use of long-acting reversible contraceptives (LARCs), including IUDs, has increased nearly fi ve-fold in the last decade among 15 to 44-year-old women.…”

Section: Introductionmentioning

confidence: 99%

“…From 2011-2013, LARC use was three times greater in parous women than nulliparous women [2]. Many individuals, particularly nulligravidas, elect against IUD use due to concern regarding pain associated with insertion (1). However, it is unclear how much this may be due to provider-directed counseling.…”

Section: Introductionmentioning

confidence: 99%

“…The Contraceptive Choice Project demonstrated that with scripted and effi cacy-based counseling, 37% of teens (14 to 17 year olds) will choose an IUD [3]. Given the signifi cant benefi ts of IUDs, modalities to decrease insertion diffi culty and procedurerelated pain are of high clinical relevance [1].…”

Section: Introductionmentioning

confidence: 99%

“…Misoprostol, a prostaglandin E1 analogue, is well known for its use as a cervical ripening agent in labor induction [1]. It is also used for cervical ripening prior to transcervical procedures such as hysteroscopy [4], dilation and curettage, and dilation and evacuation [5].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Use of Vaginal Misoprostol Prior to Placement of an Intrauterine Device: A Review

Stockdale¹

2017

J Gynecol Res Obstet

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Clinical Group AbstractIntrauterine devices (IUD) are a highly effective and safe form of contraception. However, many individuals, particularly nulligravidas, elect against IUD use due to fear of pain associated with insertion. Misoprostol has been proposed as an agent to ease IUD insertion and decrease associated pain. However, its effi cacy in the literature is inconclusive and its use varies widely between healthcare providers. We present a review on the effi cacy of vaginal misoprostol in facilitating IUD insertion and reducing procedureassociated pain.

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Long-Acting Reversible Contraception for Adolescents

Francis

Gold

2017

JAMA Pediatr

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IMPORTANCE Adolescents have higher rates of unintended pregnancies than any other age group. Contraceptive implants and intrauterine devices (IUDs) are long-acting reversible contraceptives (LARCs) that are known to be highly effective in preventing pregnancy. New devices have recently been approved for use in adolescents, yet pediatricians may be less familiar with how to counsel adolescents about implants and IUDs.OBSERVATIONS LARC methods should be described in basic terms to adolescents, including hormone dose, method of insertion, and method of pregnancy prevention. Clinicians should appreciate the developmental stages of adolescents, discuss the most effective methods of contraception, and ensure confidentiality from their parents. Short-acting contraception methods (eg, oral contraceptives) can be used as a temporary bridge to provide coverage until a LARC method can be placed. The most common adverse effect of LARC is nuisance bleeding, which can be managed with short courses of oral contraceptives or nonsteroidal anti-inflammatory drugs.CONCLUSIONS AND RELEVANCE LARC devices constitute first-line contraceptive methods for adolescents. All clinicians, including pediatricians, can counsel about LARC even before suggesting an oral contraceptive or another less effective contraceptive method. Effective, confidential communication with sensitive language to inform adolescents of the different types of LARC is necessary to normalize offering LARC as a contraceptive option and improve its uptake among adolescents. Special clinical populations can also be offered appropriate contraceptive options inclusive of LARC.

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Interventions for pain with intrauterine device insertion

Cited by 93 publications

References 64 publications

Intrauterine levobupivacaine for pain control during intrauterine device insertion

Intrauterine levobupivacaine for pain control during intrauterine device insertion

Use of Vaginal Misoprostol Prior to Placement of an Intrauterine Device: A Review

Long-Acting Reversible Contraception for Adolescents

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