Verbal analgesia is as good as oral tramadol prior to intrauterine device (IUD) insertion, among nulliparous women: A randomized controlled trial

Yair Daykan*, Shlomo Battino, Nissim Arbib, Rina Tamir Yaniv, Ron Schonman, Zvi Klein, Jonathan Pomeranz, Meir Pomeranz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To compare two pain management strategies: oral tramadol or a verbal analgesia technique during insertion of an intrauterine device (IUD) among nulliparous women. Study design: In this randomized, controlled trial, 54 nulliparous women undergoing insertion of a levonorgestrel-releasing intrauterine device (IUD), from December 2015 to December 2018 were randomized to receive oral tramadol for analgesia or verbal analgesia prior to IUD insertion. Demographic data, clinical symptoms, visual analogue scale (VAS) and complications were reviewed from patient records. Results: There was no difference between the two groups regarding gravidity, age, smoking or body mass index. No significant differences were detected between the groups regarding the procedure, including ease of insertion (p = .415), number of insertion attempts (p = .514) and complications during the insertion (p = .150). Mean pain level by VAS was 4.5 ± 1.6 (range 2−8) for the tramadol group and 4.8 ± 2.4 (0−10) for the verbal analgesia group (p = .610). There was no spontaneous ejection of the IUD in either group, and no endometritis or discomfort that resulted in IUD removal. Conclusion: There was no benefit in using oral tramadol for analgesia prior to IUD insertion among nulliparous women. Verbal analgesia can be a suitable technique for this process and clinicians should become more familiar with its use.

Original languageEnglish
Pages (from-to)443-446
Number of pages4
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Volume258
DOIs
StatePublished - Mar 2021

Keywords

  • Analgesia
  • Intrauterine device
  • Nulliparous
  • Pain
  • Verbal analgesia

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