Comparing EMLA Cream and Ibuprofen on Pain after Insertion of Copper Intrauterine Device

Tahereh  Boryri; Farnoosh  Khojasteh

doi:10.4236/ijcm.2017.83015

Tahereh Boryri^*, Farnoosh Khojasteh

Abstract: Background and Objective: IUD is a safe, effective, and reversible method throughout the world, particularly in areas where population growth is too much. One of the main barriers to use IUD is the fear and pain of its insertion. Therefore, it is necessary to take measures to reduce the pain, and this study was conducted to investigate the effect of EMLA cream and ibuprofen on pain during IUD insertion. Materials and Methods: This randomized controlled clinical trial study was conducted on 120 women who admitted to Imam Javad health center in Zahedan in 2015-2016 for insertion of IUD. Women who admitted to this center were randomly assigned into 3 groups of EMLA group (n = 40), ibuprofen (n = 40), and control or placebo (n = 40). These women have no problem to insert IUD. Demographic data and pain level were recorded in a questionnaire based on Johnson’s Visual analog scale of pain at 3 stages of IUD insertion, and all IUDs were inserted by a midwife and then data were analyzed by SPSS software. Findings: The results of this research show that the lowest level of pain severity at three stages of insertion related to the EMLA cream (P < 0.01), while the maximum level of pain in the 3 groups related to Tenaculum. Conclusion: The results of the study showed that, compared to ibuprofen and placebo, EMLA cream is a safe method in reducing pain caused by IUD insertion in all stages of IUD insertion.

Keywords: EMLA Cream, Ibuprofen, Women-Pain Severity, IUD

Cite this paper: Boryri, T. and Khojasteh, F. (2017) Comparing EMLA Cream and Ibuprofen on Pain after Insertion of Copper Intrauterine Device. International Journal of Clinical Medicine, 8, 152-158. doi: 10.4236/ijcm.2017.83015.

References

[1] Boryri, T., Khojasteh, F. and Safarzadeh, A. (2014) Intrauterine Device Removal after 22 Years. Zahedan Journal of Research in Medicine Sciences (ZJRMS), 16, 100-101.

[2] Kaneshiro, B. and Aeby, T. (2010) Long Term Safety, Efficacy, and Patient Acceptability of the Intrauterine Copper T-380A Contraceptive Device. International Journal of Women’s Health, 2, 211-220.
https://doi.org/10.2147/IJWH.S6914

[3] Murty, J. (2003) Use and Effectiveness of Oral Analgesia When Fitting an Intrauterine Device. Journal of Family Planning & Reproductive Health Care, 29, 150-151.
https://doi.org/10.1783/147118903101197539

[4] Rodney W.M., Huff, M., Euans, D., Hutchins, C., Clement, K., McCall, J.W. III, et al. (1992) Colposcopy in Family Practice: Pilot Studies of Pain Prophylaxis and Patient Volume. The Family Practice Research Journal, 12, 91-98.

[5] De Laco, P., Marabini, A., Stefanetti, M., DelVecchio, C. and Bovicelli, L. (2000) Acceptability and Pain of Outpatient Hysteroscopy. The Journal of the American Association Gynecologic Laparoscopists, 7, 71-75.
https://doi.org/10.1016/S1074-3804(00)80012-2

[6] Mirmohamad Aliei, M., Khazaie, F., Rahnama, P., Rahimikian, F., Modarres, M., Bekhradi, R. and Montazeri, A. (2013) Effect of Lavender on Pain during Insertion of Intrauterine Device: A Clinical Trial. Journal of Babol University of Medical Sciences, 15, 93-99.

[7] Mohammad-Alizadeh-Charandabi, S., Seidi, S. and Kazemi, F. (2010) Effect of Lidocaine Gel on Pain from Copper IUD Insertion: A Randomized Double-Blind Controlled Trial. Journal of Urmia Nursing and Midwifery Faculty, 10, 119-127. (Persian).

[8] Kozman, E., Collins, P., Howard, A., Akanmu, T., Gibbs, A., Frazer, M., et al. (2001) The Effect of an Intrauterine Application of Two Percent Lignocaine Gel on Pain Perception during Vabra Endometrial Sampling: A Randomized Double-Blind, Placebo-Controlled Trial. An International Journal of Obstetrics and Gynaecology, 108, 87-89.
https://doi.org/10.1111/j.1471-0528.2001.00005.x

[9] Hubacher, D., Reyes, V., Lillo, S., Zepeda, A., Chen, P.L., Croxatto, H., et al. (2006) Pain from Copper Intrauterine Device Insertion: Randomized Trial of Prophylactic ibuprofen. American Journal of Obstetrics & Gynecology, 195, 1272-1277.
https://doi.org/10.1016/j.ajog.2006.08.022

[10] Berek, J.S. (2007) Berek & Novak’s Gynecology. 14th Edition, Lippincott Williams and Wilkins, Philadelphia, 1.

[11] Tolcher, R. (2003) Intrauterine Techniques: Contentious or Consensus Opinion. Journal of Family Planning & Reproductive Health Care, 29, 21-24.
https://doi.org/10.1783/147118903101196846

[12] Tavakolian, S., Doulabi, M.A., Baghban, A.A., Mortazavi, A., Ghorbani, M. (2015) Lidocaine-Prilocaine Cream as Analgesia for IUD Insertion: A Prospective, Randomized, Controlled, Triple Blinded Study. Global Journal of Health Science, 7, 399.

[13] Zilbert, A. (2002) Topical Anesthesia for Minor Gynecological Procedures: A Review. Obstetrical Gynecological Survey, 57, 171-178.
https://doi.org/10.1097/00006254-200203000-00022

[14] Zullo, F., Pellicano, M., Stiglano, C.M., Di Carlo, C., Fabrizio, A., Nappi, C., et al. (1999) Topical Anesthesia for Office Hysteroscopy: A Prospective, Randomized Study Comparing Two Modalities. The Journal of Reproductive Medicine, 44, 865-869.

[15] Liberty, G., Gal, M., Halevey-Shalem, T., Michaelson-Cohen, R., Galoyan, N., Hyman, J., et al. (2007) Lidocaine-Prilocaine (EMLA) Cream as Analgesia for Hysterosalpingography: A Prospective, Randomized, Controlled, Double Blinded Study. Human Reproduction, 22, 1335-1339.
https://doi.org/10.1093/humrep/del517

[16] Allen, R.H., Bartz, D., Grimes, D.A., Hubacher, D. and Brien, P. (2009) Interventions for Pain with Intrauterine Device Insertion. US National Library of Medicine National Institutes of Health, 8, CD007373.

[17] Wall, P.D. and Melzack, R. (2006) Textbook of Pain. 4th Edition, Churchill Livingstone, Edinburge, 641-644.

[18] McNicholas, C.P., Madden, T., Zhao, Q., Secura, G., Allsworth, J.E. and Peipert, J.F. (2012) Cervical Lidocaine for IUD Insertional Pain: A Randomized Controlled Trial. American Journal of Obstetrics & Gynecology, 207, 384.e1-384.e6.
https://doi.org/10.1016/j.ajog.2012.09.018

[19] Stigliano, C.M., Mollo, A. and Zullo, F. (1997) Two Modalities of Topical Anesthesia for Office Hysteroscopy. International Journal of Gynaecology & Obstetrics, 59, 151-152.
https://doi.org/10.1016/S0020-7292(97)00183-5

[20] Tavakolian, S., Doulabi, M.A., Baghban, A.A., Mortazavi, A. and Ghorbani, M. (2015) Lidocaine-Prilocaine Cream as Analgesia for IUD Insertion: A Prospective, Randomized, Controlled, Triple Blinded Study. Global Journal of Health Science, 7, 399-404.

[21] –Bednarek, P.H., Creinin, M.D., Reeves, M.F., Cwiak, C., Espey, E. and Jensen, J.T. (2015) Prophylactic Ibuprofen Does Not Improve Pain with IUD Insertion: A Randomized Trial. An International Reproductive Health Journal Contraception, 91, 193-197.
https://doi.org/10.1016/j.contraception.2014.11.012

[22] Jafari, A., Sayyahi, M., Torkashvand, R. and Piryaei, H. (2014) Effect of Vitamin B1 on Pain after Insertion of Intrauterine Device. Journal of Babol University of Medical Sciences, 16, 13-20.