Lidocaine-Prilocaine Cream as Analgesia for IUD Insertion: A Prospective, Randomized, Controlled, Triple Blinded Study

Tavakolian, Samira; Doulabi, Mahbobeh Ahmadi; Baghban, Alireza Akbarzade; Mortazavi, Alireza; Ghorbani, Maryam

doi:10.5539/gjhs.v7n4p399

Cited by 32 publications

(41 citation statements)

References 16 publications

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“…In many of the clinics, ibuprofen and preparations, non-steroidal drugs, anti-inflammatory drugs, and cervical emollient drugs (misoprostol) and a topical anesthetics to alleviate the pain during the IUD insertion are used [5] [7] [10]. One a local anesthetic drugs is EMLA cream 5% that each gram of this cream contains lidocaine 25 mg and prilocaine 25 mg [12]. The analgesics application of this cream is topical on the cervix made to perform laser surgery procedures, hysteroscopy, and Hysterosalpingography [13] [14] [15].…”

Section: Introductionmentioning

confidence: 99%

Comparing EMLA Cream and Ibuprofen on Pain after Insertion of Copper Intrauterine Device

Boryri¹,

Khojasteh²

2017

IJCM

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Background and Objective: IUD is a safe, effective, and reversible method throughout the world, particularly in areas where population growth is too much. One of the main barriers to use IUD is the fear and pain of its insertion. Therefore, it is necessary to take measures to reduce the pain, and this study was conducted to investigate the effect of EMLA cream and ibuprofen on pain during IUD insertion. Materials and Methods: This randomized controlled clinical trial study was conducted on 120 women who admitted to Imam Javad health center in Zahedan in 2015-2016 for insertion of IUD. Women who admitted to this center were randomly assigned into 3 groups of EMLA group (n = 40), ibuprofen (n = 40), and control or placebo (n = 40). These women have no problem to insert IUD. Demographic data and pain level were recorded in a questionnaire based on Johnson's Visual analog scale of pain at 3 stages of IUD insertion, and all IUDs were inserted by a midwife and then data were analyzed by SPSS software. Findings: The results of this research show that the lowest level of pain severity at three stages of insertion related to the EMLA cream (P < 0.01), while the maximum level of pain in the 3 groups related to Tenaculum. Conclusion: The results of the study showed that, compared to ibuprofen and placebo, EMLA cream is a safe method in reducing pain caused by IUD insertion in all stages of IUD insertion.

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Section: Introductionmentioning

confidence: 99%

Comparing EMLA Cream and Ibuprofen on Pain after Insertion of Copper Intrauterine Device

Boryri¹,

Khojasteh²

2017

IJCM

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“…Interventions included lidocaine gel, lidocaine‐prilocaine (LP) cream, lidocaine intracervical block, lidocaine infusion, and nitroglycerin gel. Nine RCTs reported lower VAS pain scores in the treatment group compared with the control/placebo group …”

Section: Resultsmentioning

confidence: 99%

“…Although 12 RCTs were identified as being at low risk of bias within these categories, when looking at the potential for “other sources” of bias, all were seen as being at high risk due to a number of factors: they offered other analgesics besides the study drugs, recruited women who were looking for IUC placement and, in some cases, there was overlap in the VAS pain scores between treatment and placebo groups or the VAS pain scores in both groups were low (<4).…”

Section: Resultsmentioning

confidence: 99%

“…Our updated review set out to identify whether new RCTs contributed to further knowledge regarding effective pain strategies for IUC placement and identified 13 RCTs describing pharmacological interventions that result in lower pain scores when compared with placebo or control groups . The majority of these interventions involve pre‐insertion local anesthesia with lidocaine preparations.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Interventions for the prevention of pain associated with the placement of intrauterine contraceptives: An updated review

Gemzell‐Danielsson

Jensen

Monteiro

et al. 2019

Acta Obstet Gynecol Scand

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A 2013 review found no evidence to support the routine use of pain relief for intrauterine contraceptive (IUC) placement; however, fear of pain with placement continues to be a barrier to use for some women. This narrative review set out to identify (1) new evidence that may support routine use of pain management strategies for IUC placement; (2) procedure‐related approaches that may have a positive impact on the pain experience; and (3) factors that may help healthcare professionals identify women at increased risk of pain with IUC placement. A literature search of the PubMed and Cochrane library databases revealed 550 citations, from which we identified 43 new and pertinent studies for review. Thirteen randomized clinical trials, published since 2012, described reductions in placement‐related pain with administration of oral and local analgesia (oral ketorolac, local analgesia with different lidocaine formulations) and cervical priming when compared with placebo or controls. Four studies suggested that ultrasound guidance, balloon dilation, and a modified placement device may help to minimize the pain experienced with IUC placement. Eight publications suggested that previous cesarean delivery, timing of insertion relative to menstruation, dysmenorrhea, expected pain, baseline anxiety, and size of insertion tube may affect the pain experienced with IUC placement. Oral and local analgesia and cervical priming can be effective in minimizing IUC placement‐related pain when compared with placebo, but routine use remains subject for debate. Predictive factors may help healthcare professionals to identify women at risk of experiencing pain. Targeted use of effective strategies in these women may be a useful approach while research continues in this area.

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“…22,23 Nevertheless, there are studies being published which show that topical use of different formulations involving high concentrations of lidocaine mitigates IUD insertion pain at every step of the procedure. [24][25][26] It was shown that paracervical blockage in injectable applications of local anesthetics mitigates IUD application pain but intracervical injectival application is not effective on the pain. 3,27 In consideration of injection's own pain and possible adverse reactions, topical application of local anesthetics is regarded as being more advisable.…”

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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Lidocaine-Prilocaine Cream as Analgesia for IUD Insertion: A Prospective, Randomized, Controlled, Triple Blinded Study

Cited by 32 publications

References 16 publications

Comparing EMLA Cream and Ibuprofen on Pain after Insertion of Copper Intrauterine Device

Comparing EMLA Cream and Ibuprofen on Pain after Insertion of Copper Intrauterine Device

Interventions for the prevention of pain associated with the placement of intrauterine contraceptives: An updated review

Intrauterine levobupivacaine for pain control during intrauterine device insertion

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