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

Cırık, Derya Akdağ; Taşkın, Elif Aylin; Tuğlu, Alper; Ortaç, Arzu Sümer; Dai, Omer

doi:10.5455/2320-1770.ijrcog20130902

Cited by 17 publications

(11 citation statements)

References 12 publications

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“…In this review, two randomized controlled trials found significantly reduced pain at either tenaculum placement or IUD insertion among women receiving paracervical block with 1% lidocaine 3-5 minutes before IUD insertion (118,119). Neither trial found differences in side effects among women receiving paracervical block compared with controls (Level of evidence: I, moderate to low quality) (118,119).…”

Section: Provision Of Medications To Ease Iud Insertionmentioning

confidence: 91%

U.S. Selected Practice Recommendations for Contraceptive Use, 2016

Curtis

Jatlaoui²,

Tepper³

et al. 2016

MMWR Recomm. Rep.

344

351

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The 2016 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR) addresses a select group of common, yet sometimes controversial or complex, issues regarding initiation and use of specific contraceptive methods. These recommendations for health care providers were updated by CDC after review of the scientific evidence and consultation with national experts who met in Atlanta, Georgia, during August 26-28, 2015. The information in this report updates the 2013 U.S. SPR (CDC. U.S. selected practice recommendations for contraceptive use, 2013. MMWR 2013;62[No. RR-5]). Major updates include 1) revised recommendations for starting regular contraception after the use of emergency contraceptive pills and 2) new recommendations for the use of medications to ease insertion of intrauterine devices. The recommendations in this report are intended to serve as a source of clinical guidance for health care providers and provide evidence-based guidance to reduce medical barriers to contraception access and use. Health care providers should always consider the individual clinical circumstances of each person seeking family planning services. This report is not intended to be a substitute for professional medical advice for individual patients. Persons should seek advice from their health care providers when considering family planning options.

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Section: Provision Of Medications To Ease Iud Insertionmentioning

confidence: 91%

U.S. Selected Practice Recommendations for Contraceptive Use, 2016

Curtis

Jatlaoui²,

Tepper³

et al. 2016

MMWR Recomm. Rep.

344

351

View full text Add to dashboard Cite

show abstract

“…The analysis of a randomised trial of para‐cervical block of 1% lidocaine (Cirik et al . ) includes the observation that ‘Pain experienced during injection was not reported. Further studies are required to fully evaluate the use of LA cervical block for straightforward IUC insertion’ (FSRH , p. 22).…”

Section: Resultsmentioning

confidence: 99%

“…However, local anaesthetic block administered by cervical injection 'should be offered when cervical dilatation is required or difficult IUC insertion or removal is anticipated/ experienced' (FSRH 2015 p. 22). The analysis of a randomised trial of para-cervical block of 1% lidocaine (Cirik et al 2013) includes the observation that 'Pain experienced during injection was not reported. Further studies are required to fully evaluate the use of LA cervical block for straightforward IUC insertion' (FSRH 2015, p. 22).…”

Section: Analgesia and Anaesthesiamentioning

confidence: 99%

Intrauterine contraception insertion pain: nursing interventions to improve patient experience

McCarthy

2017

Journal of Clinical Nursing

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Aims and objectives. To examine factors which contribute to the individual's experience of pain in relation to intrauterine contraception insertion and determine evidence-based nursing strategies to best assess and manage this pain. Background. Nurses are increasingly involved in consultations regarding intrauterine contraception. However, concerns regarding painful or difficult insertion may inhibit uptake and discourage nurses from promoting or inserting intrauterine contraception. Design. Integrative review. Methods. Database searches of CINAHL, PubMed, Wiley Online Library and the Cochrane Collaboration for relevant literature. Eight papers met the inclusion criteria and were analysed using an integrative review process. Results. Physical causes and pharmacological interventions for insertion pain have been thoroughly investigated. Absence of previous vaginal delivery and anxiety may increase the likelihood of procedural pain. The literature fails to conclusively determine any universally effective prophylactic analgesia. Cervical anaesthesia may be beneficial in some cases and oral analgesia may relieve postprocedural pain. Distraction in the form of conversation, music or television can be effective in reducing anxiety. Conclusions. A combination of physical, psychological and environmental factors contribute to the individual's pain experience. Nurses have the potential to make a significant impact on pain outcomes by demonstrating clinical expertise and creating a trustful environment. Giving reliable information, acknowledging the significance of anxiety and providing reassurance and distraction are effective pain reducing strategies. Research into nonpharmacological approaches is warranted, especially those which reduce anxiety. Relevance to clinical practice. Increasing uptake of long-acting reversible contraception is a public health goal. Providing effective pain management strategies to improve patient experience may encourage more nurses to recommend, or enhance their scope of practice to include, intrauterine contraception insertion.

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“…Several studies also found increased side effects (e.g., cramping, shivering, headache, abdominal pain) among women receiving misoprostol versus placebo. The review suggested that paracervical block with lidocaine may reduce patient pain based on two RCTs [47,49] that found significantly reduced pain at either tenaculum placement or IUD insertion among women receiving paracervical block with 1% lidocaine 3–5 min before IUD insertion. The review also suggested that tramadol and naproxen may have some effect on reducing IUD insertion-related pain, but the RCTs [40,41] examining these medications included IUDs not available in the United States (i.e., Dalkon Shield, Multiload copper 375).…”

Section: Discussionmentioning

confidence: 99%