Intrauterine Lidocaine and Naproxen for Analgesia During Intrauterine Device Insertion: Randomized Controlled Trial

Overview

Journal Contracept Reprod Med

Publisher Biomed Central

Specialty Reproductive Medicine

Date 2019 Sep 14

PMID 31516731

Citations 2

Authors

Shana M Miles

Katerina Shvartsman

Susan Dunlow

Affiliations

Soon will be listed here.

Abstract

Background: This study evaluates oral naproxen and intrauterine instillation of lidocaine for analgesia with intrauterine device (IUD) placement as compared to placebo.

Methods: This was a randomized, double-blind, placebo-controlled trial. Patients desiring levonorgestrel 52 mg IUD or Copper T380A IUD were randomized into treatment groups. Patients received either oral naproxen 375 mg or placebo approximately 1 h prior to procedure in conjunction with 5 mL of 2% lidocaine or 5 mL of intrauterine saline. The primary outcome was pain with IUD insertion measured on a visual analog scale immediately following the procedure. Prespecified secondary outcomes included physician pain assessment, post procedure analgesia, satisfaction with procedure, satisfaction with IUD, and pain assessment related to IUD type.

Results: From June 4, 2014 to October 28, 2016 a total of 160 women desiring Copper T380A or levonorgestrel 52 mg intrauterine device insertion and meeting study criteria were enrolled and randomized in the study. Of these, 157 (78 in the Copper T380A arm, 79 in the levonorgestrel 52 mg) received study treatment medication. There were 39 in naproxen/lidocaine arm, 39 in placebo/lidocaine arm, 40 in naproxen/placebo arm, and 39 in placebo/placebo arm. There were no differences in the mean pain scores for IUD placement between treatment groups (naproxen/lidocaine 3.38 ± 2.49; lidocaine only 2.87 ± 2.13; naproxen only 3.09 ± 2.18; placebo 3.62 ± 2.45). There was no difference in self-medication post procedure or in satisfaction with the procedure and IUD among women in the treatment arms or by type of IUD.

Conclusion: Naproxen with or without intrauterine lidocaine does not reduce pain with IUD placement.

Clinical Trial Registration: Clinicaltrials.gov, NCT02769247. Registered May 11, 2016, Retrospectively registered.

Citing Articles

Provider Perspectives on Analgesic Use in Intrauterine Device Insertion Procedures: A Mixed Methods Analysis.

Daidone C, Morris K, Colquitt J, Jackson G Cureus. 2024; 16(3):e56580.

PMID: 38646269 PMC: 11031185. DOI: 10.7759/cureus.56580.

Differing Approaches to Pain Management for Intrauterine Device Insertion and Maintenance: A Scoping Review.

Rahman M, King C, Saikaly R, Sosa M, Sibaja K, Tran B Cureus. 2024; 16(3):e55785.

PMID: 38586685 PMC: 10999118. DOI: 10.7759/cureus.55785.

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