Cervical lidocaine for IUD insertional pain: a randomized controlled trial.
Author(s): McNicholas CP, Madden T, Zhao Q, Secura G, Allsworth JE, Peipert JF.
Affiliation(s): Division of Clinical Research, Department of Obstetrics and Gynecology,
Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA.
mcnicholasc@wudosis.wustl.edu
Publication date & source: 2012, Am J Obstet Gynecol. , 207(5):384
OBJECTIVE: Anticipated pain with intrauterine device (IUD) insertion may be a
barrier to widespread use. Our objective was to evaluate the efficacy of
intracervical 2% lidocaine gel for pain relief with IUD insertion.
STUDY DESIGN: We performed a double-blind, randomized controlled trial of women
undergoing IUD insertion. Participants were randomly assigned to 2% lidocaine or
placebo gel. Study gel (3 mL) was placed 3 minutes prior to IUD insertion. Pain
scores were measured at various time points using a 10-point visual analog scale.
RESULTS: Of the 200 participants randomized, 199 completed the study. Pain scores
among lidocaine and placebo arms were similar at tenaculum placement (lidocaine
and placebo: median, 4; range, 0-10; P = .15) and with insertion (lidocaine:
median, 5; range, 1-10; placebo: median, 6; range, 0-10; P = .16). These results
did not differ by parity.
CONCLUSION: Topical or intracervical 2% lidocaine gel prior to IUD insertion does
not decrease pain scores.
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