Intrauterine levobupivacaine for pain control during intrauterine device insertion

Abstract

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.

Role of intrauterine instillation of levobupivacaine as a local anaesthetic for outpatient gynaecological procedures: a randomized controlled study

“…Akgun N et al, performed a similar study on 95 patients during IUD insertion comparing intrauterine instillation of levobupivacaine with control group and pain was assessed at similar four steps, with the help of visual analogue scale (VAS). 3 The mean pain score using VAS during tenaculum placement and solution instillation showed no significant difference in between the two groups (p values 0.105 and 0.241 respectively), while the mean pain score using VAS during IUD insertion and 15 minutes after the procedure was lower in study group as compared to control group (p value <0.001 and <0.001 respectively). Similarly, Kosus N, et al studied transcervical intrauterine levobupivacaine and lidocaine infusion for pain control during endometrial biopsy in 99 patients.…”