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Article Type

Original Study

Abstract

Objectives Pain with intrauterine device (IUD) insertion may be a barrier to widespread use. Our objective was to evaluate the efficacy of 1% lidocaine paracervical block for pain relief with IUD insertion compared with NSAIDs. Background The IUD provides long-term, reversible contraception equal in efficacy to tubal sterilization. The IUD is one of the safest, least expensive, and most effective contraceptive methods available. The IUD is often an excellent choice for women who do not anticipate future pregnancies but wish not to be sterilized. Patients and methods We performed a randomized clinical controlled trial of women undergoing IUD insertion. Participants were randomly assigned to receive either 10 ml of 1% lidocaine paracervical block or oral naproxen or placebo tablets before IUD insertion. Pain scores were measured using a 10-point visual analogue scale at various time points of procedure (speculum placement, tenaculum placement, during IUD insertion, and 15 min after the procedure). Results Of the 150 participants randomized, 50 women received the paracervical block, 50 women received NSAIDs, and 50 women received placebo tablets before IUD insertion. Groups were similar in age, parity, ethnicity, education, and complications. Pain scores were similar among the three groups at tenaculum placement (mean ± SD = 4.84 ± 1.39, 4.76 ± 1.28, and 4.70 ± 1.21, respectively; P = 0.938) as well as during insertion (mean ± SD = 5.30 ± 1.61, 4.90 ± 1.24, and 5.16 ± 1.20, respectively; P = 0.460). These results did not differ during speculum placement and after procedure. Conclusion 1% lidocaine paracervical block, as well as NSAIDs, before IUD insertion does not decrease pain scores.

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