Abstract

PIP: Experience with paracervical and intracervical block for first trimester suction aspiration abortion and endometrial biopsy has shown the efficacy of this form of anesthesia in reducing discomfort during vaginal procedures on the cervix and uterus in conscious women. Since 1975, the author has used intracervical block with 8-10 cm of 1% xylocaine for all IUD insertions, unless requested by the patient not to do so. The described technique is simple, low cost, requires no special equipment, and adds no more than 30-60 seconds to insertion time. Patients do not feel the injection of local anesthetic solution. The advantages of using a local anesthetic are as follows: 1) minimal discomfort felt during insertion; 2) postinsertion cramping is eliminated or greatly reduced; 3) elimination of cervical shock or vasovagal reaction during or just after insertion; 4) maximal patient cooperation allowing easier attainment of absolute no touch technique and ensuring correct placement of the device; 5) reduction in recovery and resting time following insertion; and 6) a positive influence on patient acceptance of the device due to pain-free insertion. The routine use of intracervical local anesthesia for IUD insertion is recommended as a means of achieving greater patient and doctor satisfaction and reduced insertion appointment time.