Date of Award

2027

Document Type

Capstone

Degree Name

Master of Science (MS)

Department

Physician Assistant Studies

Committee Chair

Ashley Kernicky

Abstract

Introduction: Intrauterine devices provide long-acting reversible contraception for women wanting to prevent pregnancy, but pain during insertion is a major concern for many patients. This clinical review compared nonsteroidal anti-inflammatory drugs and local anesthetic options for pain control during and shortly following IUD insertion.

Methods: PubMed was searched using terms “intrauterine device insertion”, “nonsteroidal anti-inflammatory drugs”, “lidocaine”, “local anesthetics”, “pain”, and “analgesia”. The search returned 135 articles. After filters were applied, eleven articles remained, and five articles met the inclusion criteria and were selected for the clinical review.

Results: The review included four randomized controlled trials and one network meta-analysis. Local anesthetic approaches generally reduced pain during insertion. Oral naproxen was less effective than intracervical lidocaine, and a ketorolac-based regimen did not reduce pain during the procedure but did lower pain ten minutes afterward.

Discussion: The studies support offering a local anesthetic when procedural pain is a primary concern. Nonsteroidal anti-inflammatory drugs may help with cramping after placement, but the evidence does not support relying on them alone for pain control during insertion.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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