EFFECT OF LIDOCAINE GEL ON PAIN FROM COPPER IUD INSERTION: A RANDOMIZED DOBELL BLIND CONTROLLED TRIAL

The copper bearing intrauterine device (IUD) is a long-term, reversible
contraception method that is as effective as tubal sterilization. Its insertion pain or fear of it may make
women hesitate to use an IUD. This study aimed to determine the effect of lidocaine gel on pain from
copper IUD insertion.
Materials & Methods: This study was done among 96 women at a health center in Tabriz. The
subjects were allocated into three groups using random blocking with 6 and 9 block sizes considering
allocation concealment. Inone group, lidocaine 2% gel and in the second, lubricant gel was placed in
the cervical canal by a sterile swab one minute before IUD insertion and the third group got no
intervention. IUD inserter was blind for the gels used and subjects and the pain assessor were blind for
intervention. One expert midwife inserted all the IUDs. Immediately after IUD insertion, pain during
the insertion was measured using 0-10 cm visual analogue scale, with the value of 10 meaning ‘‘worst
imaginable pain.’’One way ANOVA, Kruskal-Wallis, unpaired t-test, Mann-Whitney and linear
regression in SPSS-13 were used to identify effect of lidocaine gel on the pain.
Result: Overall, the mean pain score was 3.5±1.8. In univariate analysis, there was no significant
difference in pain scores between three groups. Comparison of frequencies and univariate analysis
showed difference in some possible confounding factors between the groups. Results of linear
regression model by controlling effect of the possible confounding factors including history of vaginal
delivery, interval from the last delivery, situation of lactation, history of IUD insertion and the interval
of cervix wash and pain assessment showed no significant effect of lidocaine gel on the insertion pain.
The mean pain score in the lidocaine group was 0.39 less than in the control group but it was no
significant (CI 95% of the difference: -1.3, 0.57).
Conclusion: Use of 2% lidocaine gel and also use of lubricant gel into the cervical canal, one minute
before putting on cervical tenaculum, has no effect on reducing overall pain during IUD insertion