[Prophylactic use of prostaglandin synthesis inhibitors in connection with IUD insertion]

Abstract

In a double-blind, randomized, placebo-controlled study conducted at a contraception clinic, 55 women (three nulliparous) were given either ibuprofen 600 mg or placebo 1-4 hours prior to insertion of IUD, 4-6 hours after insertion of IUD and the following morning. Pain was assessed by ten point Numerical Rating Scales during insertion, in the first 4-6 hours and in the following three days. No benefit of ibuprofen was demonstrated at insertion or at any other time during the first three days. The patients were further randomized to type of IUD: TCu-380A and Nova T (R.). No difference in pain scores was evaluated between these.

PIP: In a double-blind, randomized, placebo-controlled study conducted at a family planning clinic in Herlev, County of Copenhagen, during the period of May 1994 to May 1995, a total of 55 women were randomized in the following 4 groups according to treatment: 1) ibuprofen and the Gyne T 380 IUD, 2) ibuprofen and Nova T IUD, 3) placebo and Gyne T 380 IUD, and 4) placebo and Nova T IUD. All women were given either ibuprofen 600 mg or placebo 1-4 hours prior to insertion of an IUD, 4-6 hours after insertion, and the morning after insertion. Pain was assessed by a 10-point Numerical Rating Scale during insertion, in the first 4-6 hours, and over the following 3 days. The median values of pain intensity for Nova T and Gyne T were 3.0/2.9 at insertion, 1.6/1.9 during the first 4-6 hours, 1.3/1.5 during the first day, 1.1/1.3 the next day, and 1.1/1.1 on the third day after insertion. The median values of pain intensity for the ibuprofen/placebo groups were 3.3/2.5 at insertion, 1.7/1.8 during the first 4-6 hours, 1.4/1.3 during the first day, 1.3/1.1 the next day, and 1.1/1.1 on the third day after insertion. Among the women who had just given birth only 6% had intensity of pain over point 3 after 4-6 hours and none of them had it beyond the first day. 38% had significantly more pain (3) at insertion; this problem could be prevented by local anesthesia. No benefit of ibuprofen was demonstrated at insertion or at any other time during the first three days. The patients were further randomized according to the type of IUD: TCu-380A and Nova T. No difference in pain scores was ascertained between these groups.