Effects of prophylactic misoprostol administration prior to intrauterine device insertion in nulliparous women

Edelman, Alison; Schaefer, Elizabeth; Olson, Amanda; Houten, Laura Van; Bednarek, Paula H.; Leclair, Catherine M.; Jensen, Jeffrey T.

doi:10.1016/j.contraception.2011.01.016

Cited by 87 publications

(57 citation statements)

References 17 publications

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“…However, reducing pain with IUD insertion among nulliparous women may increase the acceptability of this highly effective contraceptive method for this group. NSAIDs, intracervical lidocaine [28], nitric oxide donors [21,22] and misoprostol [29] have all been studied, but none have been shown to be effective. Given the important public health need to reduce barriers to IUD utilization overall, further investigations should concentrate on alternate strategies to reduce pain and improve satisfaction with IUD insertion among nulliparous women.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic ibuprofen does not improve pain with IUD insertion: a randomized trial

et al. 2015

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TitleProphylactic ibuprofen does not improve pain with IUD insertion: a randomized trial. AbstractObjective: To evaluate if ibuprofen 800 mg reduces pain with intrauterine device (IUD) insertion among U.S. women. Study design: We conducted a randomized, double-blind, placebo-controlled trial of women undergoing IUD insertion approximately 2-6 weeks following first-trimester uterine aspiration. Subjects were randomized to receive ibuprofen 800 mg or placebo 30-45 min prior to IUD insertion. A 100-mm visual analog scale (VAS) was administered to measure pain after speculum insertion (baseline) and immediately following IUD insertion.Results: A total of 202 women were enrolled, with 101 randomized to each group (ibuprofen or placebo). Sociodemographic characteristics and baseline VAS scores were similar between groups. The median pain score with IUD insertion was 41.5 mm in the placebo group and 38.0 mm in the ibuprofen group (p=.50). Mean and median pain scores did not differ between placebo and ibuprofen when nulliparous and parous women were analyzed independently. Overall, median pain scores were 17.5 mm higher in nulliparous women than parous women (p=.004). Median pain scores did not differ by age, IUD-type, history of dysmenorrhea or time since aspiration. Conclusions: Administration of ibuprofen 800 mg prior to IUD insertion does not reduce pain associated with the procedure for U.S. women. Overall, nulliparous women report more pain with IUD insertion than multiparous women.

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Section: Discussionmentioning

confidence: 99%

Prophylactic ibuprofen does not improve pain with IUD insertion: a randomized trial

et al. 2015

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“…Paracervical blocks, pre-procedure ibuprofen, intracervical or intrauterine lidocaine, and misoprostol are some of the interventions that have been studied without success [4][5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Effect of an atraumatic vulsellum versus a single-tooth tenaculum on pain perception during intrauterine device insertion: a randomized controlled trial

Doty

MacIsaac

2015

Contraception

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“…5 Similarly buccal and vaginal misoprostol application to nulliparous women before IUD insertion was reported to be ineffective for pain control and also associated with side effects. 6,7,8 McNicholas et al randomized 199 women to either Lidocaine or placebo gel groups and applied gels to both ectocervix and endocervix (via catheter). 9 Tenaculum and IUD were applied 3 minutes after the gel is used, and pain scores were found to be statistically similar.…”

Section: Discussionmentioning

confidence: 99%

Paracervical block with 1% lidocaine for pain control during intrauterine device insertion: a prospective, single-blinded, controlled study

Cırık

Taşkın²,

Tuğlu

et al. 2013

Int J Reprod Contracept Obstet Gynecol

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In this prospective controlled study we aimed to investigate efficacy of paracervical block with 1% Lidocaine for pain control and demographic variables which may affect pain perception during intrauterine device insertion in Turkish women. Data from 95 women assigned to paracervical block (n=34), placebo (n=30) and no treatment (n=31) arms and asked to grade the pain level they felt during tenaculum placement, intrauterine device insertion and 5 minutes after the procedure using a visual pain scale. Demographic variables were also recorded. Pain scores were found to be lower in paracervical block group when compared to other 2 groups during tenaculum placement (p=0.00), intrauterine device insertion (p=0.00) and 5 minutes after the procedure (p=0.00). Level of pain was unrelated to mode of previous deliveries and current breastfeeding. Paracervical block is an easy, safe and effective way of pain control during intrauterine device insertion. Lack of vaginal birth history is not a reason to draw back from intrauterine device use. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000): 263-267

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Effects of prophylactic misoprostol administration prior to intrauterine device insertion in nulliparous women

Cited by 87 publications

References 17 publications

Prophylactic ibuprofen does not improve pain with IUD insertion: a randomized trial

Prophylactic ibuprofen does not improve pain with IUD insertion: a randomized trial

Effect of an atraumatic vulsellum versus a single-tooth tenaculum on pain perception during intrauterine device insertion: a randomized controlled trial

Paracervical block with 1% lidocaine for pain control during intrauterine device insertion: a prospective, single-blinded, controlled study

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