Cochrane · systematic review · CD007373
Interventions for pain with intrauterine device insertion
Lopez, LM, Bernholc, A, Zeng, Y, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
Fertility RegulationAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
23
current version
GRADE rated
23
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 4 · 17.4%Moderate 15 · 65.2%High 4 · 17.4%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings: lidocaine 2% gel
Population: women with IUC being inserted
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain score at tenaculum placement (10 cm or 100 mm VAS) | no estimate extracted | 2 studies · 345 participants | High |
Pain score during IUC insertion (10 cm or 100 mm VAS) | no estimate extracted | 3 studies · 409 participants | High |
Summary of findings: other lidocaine
Population: women with IUC being inserted
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain score at tenaculum placement (100 mm VAS) | no estimate extracted | 50 participants | Low |
Pain score for IUC insertion (10 cm VAS) | no estimate extracted | 92 participants | Moderate |
Pain score for IUC insertion (within 10 min) (100 mm VAS) | no estimate extracted | 209 participants | Moderate |
Pain score at 30 min post‐insertion (100 mm VAS) | no estimate extracted | 114 participants | Moderate |
Summary of findings: naproxen or tramadol
Population: women with IUC being inserted
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain score during IUC insertion (10‐point VAS) | no estimate extracted | 69 participants | Moderate |
Satisfaction: insertion experience was unpleasant | OR 0.02 [0.01, 0.09] | 68 participants | Moderate |
Satisfaction: would not want treatment in future | OR 0.02 [0, 0.08] | 68 participants | Moderate |
Pain score 1 hour after IUC insertion (5‐point scale) | no estimate extracted | 50 participants | Low |
Pain score 2 hours after IUC insertion (5‐point scale) | no estimate extracted | 41 participants | Low |
Summary of findings: misoprostol 400 µg
Population: women with IUC being inserted
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain score during IUC insertion (100 mm VAS) | SMD 0.27 [0.07, 0.46] | 4 studies · 400 participants | High |
Side effect: cramping (before IUC insertion) | OR 2.64 [1.46, 4.76] | 4 studies · 466 participants | High |
Moderate to severe pain at IUC insertion (dichotomous) | OR 0.3 [0.16, 0.55] | 179 participants | Low |
Satisfaction: experience was slightly or not disagreeable | OR 4.34 [2.32, 8.12] | 179 participants | Moderate |
Pain score at IUC insertion (100 mm VAS) | no estimate extracted | 73 participants | Moderate |
Pain score before leaving clinic (100 mm VAS) | no estimate extracted | 73 participants | Moderate |
Pain score for highest level before leaving clinic (100 mm VAS) | MD 7.6 [6.48, 8.72] | 105 participants | Moderate |
Summary of findings: misoprostol 400 µg + diclofenac
Population: women with IUC being inserted
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Side effect: headache | OR 5.68 [1.23, 26.19] | 255 participants | Moderate |
Side effect: abdominal pain | OR 3.93 [1.41, 10.97] | 230 participants | Moderate |
Side effect: shivering | OR 5.48 [1.41, 21.33] | 79 participants | Moderate |
Satisfaction: would choose treatment again | OR 0.3 [0.14, 0.65] | 255 participants | Moderate |
Satisfaction: would recommend treatment to friend | OR 0.36 [0.16, 0.81] | 255 participants | Moderate |