OBJECTIVE:Anticipated pain with intrauterine device (IUD) insertion may be a barrier to widespread use. Our objective was to evaluate the efficacy of intracervical 2% lidocaine gel for pain relief with IUD insertion. STUDY DESIGN:We performed a double-blind, randomized controlled trial of women undergoing IUD insertion. Participants were randomly assigned to 2% lidocaine or placebo gel. Study gel (3 mL) was placed 3 minutes prior to IUD insertion. Pain scores were measured at various time points using a 10-point visual analog scale. RESULTS:Of the 200 participants randomized, 199 completed the study. Pain scores among lidocaine and placebo arms were similar at tenaculum placement (lidocaine and placebo: median, 4; range, 0-10; P = .15) and with insertion (lidocaine: median, 5; range, 1-10; placebo: median, 6; range, 0-10; P = .16). These results did not differ by parity. CONCLUSION:Topical or intracervical 2% lidocaine gel prior to IUD insertion does not decrease pain scores.

译文

目的:宫内节育器(IUD)插入会导致预期的疼痛可能是广泛使用的障碍。我们的目标是评估2%利多卡因腹腔内凝胶治疗宫内节育器疼痛缓解的效果。
研究设计:我们对接受宫内节育器植入的妇女进行了一项双盲,随机对照试验。参与者被随机分配到2%利多卡因或安慰剂凝胶中。在插入宫内节育器之前3分钟放置研究凝胶(3 mL)。使用10点视觉模拟量表在各个时间点测量疼痛评分。
结果:在随机分配的200名参与者中,有199名完成了研究。利多卡因和安慰剂组之间的疼痛评分在触角放置(利多卡因和安慰剂:中位数,4;范围,0-10; P = .15)和插入时相似(利多卡因:中位数,5;范围,1-10;安慰剂:中位数为6;范围为0-10; P = 0.16)。这些结果在均等方面没有差异。
结论:在宫内节育器插入前局部或颅内使用2%利多卡因凝胶不会降低疼痛评分。

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