Higher dose cervical 2% lidocaine gel for IUD insertion: a randomized controlled
trial.
Author(s): Allen RH(1), Raker C, Goyal V.
Affiliation(s): Author information:
(1)Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown
University, Women and Infants Hospital, Providence, RI 02905, USA. Electronic
address: rhallen@wihri.org.
Publication date & source: 2013, Contraception. , 88(6):730-6
OBJECTIVE: To determine the effectiveness of 6 mL of 2% lidocaine cervical gel
for pain during intrauterine device (IUD) insertion.
STUDY DESIGN: This is a randomized double-blind placebo controlled trial of 6 mL
of 2% lidocaine gel for IUD insertion pain among first-time IUD users. No other
analgesia other than the study intervention was provided. The study was conducted
at a university-based obstetrics and gynecology clinic. The primary outcome, pain
during IUD insertion on a 0 to 100-mm visual analog scale, was analyzed using the
t test.
RESULTS: Seventy-three women received placebo gel, and 72 women received 2%
lidocaine gel. The groups had similar sociodemographic and clinical
characteristics. Baseline pain scores with speculum insertion were no different
between the two groups. The lidocaine group reported a mean pain score with
tenaculum placement of 37.5 (median: 39) compared to the placebo group of 41.6
(median: 37) (p=.4). Similarly, pain with IUD insertion was no different with a
mean pain score of 35.2 (median: 34) in the lidocaine group and 36.7 (median 36)
in the placebo group (p=.8).
CONCLUSIONS: Two percent lidocaine gel placed on the anterior lip of the cervix
and at the internal os did not reduce pain with tenaculum placement and IUD
insertion compared to placebo gel.
IMPLICATIONS: Among first-time IUD users, including both nulliparous and
multiparous women, 6 mL of 2% lidocaine gel placed on the anterior lip of the
cervix and at the internal os for 3 min did not reduce pain with tenaculum
placement and IUD insertion compared to placebo gel.
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