Non-invasive intrauterine instillation of Mepivacain for pain relief at insertion of intrauterine devices: A double-blind randomized controlled trial.
ESC Congress Library. Envall N. May 10, 2018; 208071; ESC25
Mr. Niklas Envall
Mr. Niklas Envall
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Abstract Objective: To evaluate whether intrauterine instillation with Mepivacain (Carbocain®) during insertion of an intrauterine contraceptive device (IUD) decrease pain experience compared with placebo (NaCl). Design: A double-blind randomized controlled trial. Setting: Two outpatient clinics providing contraceptive services in Stockholm County, Sweden. Population: 81 Women over 18 years of age opting for IUD for contraception. Methods: Women were randomized to intrauterine instillation of Mepivacain or placebo (NaCl) with a hydrosonography catheter before insertion of an IUD. During the insertion women marked their pain experience on a 10-cm visual analogue scale (VAS). Data were analyzed by intention to treat, using descriptive and inferential statistics. Main outcome measures: Difference in pain score (VAS) at the time of the insertion of the IUD between treatment and placebo group. Results: Mean VAS-score was 4,63 in the treatment group (n=41, SD=2,21) compared to 5,67 in the placebo group (n=40, SD=2,62). The results were analyzed using multivariate linear regression. The intervention did not have a significant influence on the VAS-score (p=0.058).                                          Conclusions: Intrauterine instillation of Mepivacain prior to insertion of an IUD was associated with a lower pain experience compared to placebo but the intervention did not have a significant influence on the pain score. Our findings support further studies with larger sample sizes. Funding: Grants for research, development and education (ALF) from Stockholm County Counsil. Keywords: intrauterine devices; contraception; IUD; IUS; non-invasive, pain; VAS; Mepivacain; Carbocain Tweetable abstract: Intrauterine Mepivacain/Carbocain as pain relief during IUD insertion looks promising, larger studies needed.
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