Pain from copper intrauterine device insertion: Randomized trial of prophylactic ibuprofen

Hubacher, David; Reyes, Verónica; Lillo, S.; Zepeda, Ana; Chen, Pai Lien; Croxatto, H

doi:10.1016/j.ajog.2006.08.022

Cited by 165 publications

(102 citation statements)

References 15 publications

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“…Previous studies demonstrate similar pain scores between American nulligravid and nulliparous women who have had previous early pregnancies, as in our study [21,22]. In contrast, pain levels with IUD insertion reported by Chilean women are comparably low for both groups {mean pain score on a 100-mm VAS of 28 mm [95% confidence interval (CI) 20-35 mm] for the nulliparous group and 20 mm (95% CI 18-21 mm) for the multiparous group} [7]. Accordingly, it appears that women in Chile experience less pain overall with IUD insertion compared to U.S. or European women.…”

Section: Discussionsupporting

confidence: 80%

“…Although nonsteroidal antiinflammatory drugs (NSAIDs) are commonly used prior to IUD insertion to decrease pain, no data support the utility of this practice, including use specifically in nulliparous women [6,7]. The largest trial of NSAIDs prior to IUD insertion used ibuprofen 400 mg, a dose lower than is commonly recommended in the United States [7].…”

Section: Introductionmentioning

confidence: 99%

“…The largest trial of NSAIDs prior to IUD insertion used ibuprofen 400 mg, a dose lower than is commonly recommended in the United States [7]. Interestingly, NSAIDs are often recommended prior to other office-based gynecologic procedures, such as colposcopy [8], endometrial biopsy [9] and dilation and curettage [10][11][12], though data are mixed about their effectiveness with these procedures as well.…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2015

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“…The factors that cause increased pain during IUD insertion include being nullipara by the person, the age of more than 30 years, long time distance from the last menstruation or pregnancy and breastfeeding, and lack of natural childbirth, history of inserting IUD [9]. In the case of non-relieving of the pain, these factors increase the risk of shock and vasovagal and dangerous cardiac arrhythmia [10] [11].…”

Section: Introductionmentioning

confidence: 99%

Comparing EMLA Cream and Ibuprofen on Pain after Insertion of Copper Intrauterine Device

Boryri¹,

Khojasteh²

2017

IJCM

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Background and Objective: IUD is a safe, effective, and reversible method throughout the world, particularly in areas where population growth is too much. One of the main barriers to use IUD is the fear and pain of its insertion. Therefore, it is necessary to take measures to reduce the pain, and this study was conducted to investigate the effect of EMLA cream and ibuprofen on pain during IUD insertion. Materials and Methods: This randomized controlled clinical trial study was conducted on 120 women who admitted to Imam Javad health center in Zahedan in 2015-2016 for insertion of IUD. Women who admitted to this center were randomly assigned into 3 groups of EMLA group (n = 40), ibuprofen (n = 40), and control or placebo (n = 40). These women have no problem to insert IUD. Demographic data and pain level were recorded in a questionnaire based on Johnson's Visual analog scale of pain at 3 stages of IUD insertion, and all IUDs were inserted by a midwife and then data were analyzed by SPSS software. Findings: The results of this research show that the lowest level of pain severity at three stages of insertion related to the EMLA cream (P < 0.01), while the maximum level of pain in the 3 groups related to Tenaculum. Conclusion: The results of the study showed that, compared to ibuprofen and placebo, EMLA cream is a safe method in reducing pain caused by IUD insertion in all stages of IUD insertion.

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“…They randomized 2019 women to drug and placebo groups and found out that oral 400 mg ibuprofen taken 45 minutes before IUD insertion to be ineffective to reduce pain caused by IUD insertion. 4 Allen et al reviewed all randomized controlled studies on pain control in IUD insertion, and found both nonsteroidal analgesic and misoprostol use ineffective. 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.…”

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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Pain from copper intrauterine device insertion: Randomized trial of prophylactic ibuprofen

Cited by 165 publications

References 15 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

Comparing EMLA Cream and Ibuprofen on Pain after Insertion of Copper Intrauterine Device

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

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