Cold Compress for Intrauterine Device Insertional Pain: A Randomized Control Trial

Background: Pain with intrauterine device (IUD) insertion is identified as a barrier to uptake of this highly effective long-acting reversible contraceptive. Several studies have assessed the efficacy of interventions to alleviate patient discomfort associated with IUD insertion, but no intervention...

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Main Authors: Jordan Hylton, Sarah Milton, Adam P. Sima, Nicole W. Karjane
Format: Article
Language:English
Published: Mary Ann Liebert 2020-08-01
Series:Women's Health Reports
Subjects:
Online Access:https://www.liebertpub.com/doi/full/10.1089/WHR.2020.0056
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author Jordan Hylton
Sarah Milton
Adam P. Sima
Nicole W. Karjane
author_facet Jordan Hylton
Sarah Milton
Adam P. Sima
Nicole W. Karjane
author_sort Jordan Hylton
collection DOAJ
description Background: Pain with intrauterine device (IUD) insertion is identified as a barrier to uptake of this highly effective long-acting reversible contraceptive. Several studies have assessed the efficacy of interventions to alleviate patient discomfort associated with IUD insertion, but no interventions have been clearly shown to improve procedural pain. The aim of this study was to determine whether use of a cold compress on the abdomen during IUD insertion reduces pain. Materials and Methods: This was a prospective randomized control trial of women presenting to Virginia Commonwealth University for insertion of IUD from September 2016 to October 2017. A power analysis determined that 69 subjects were needed in each arm to detect a 30% reduction in pain with a power of 80%, significance value of p?<?0.05. One hundred forty-two participants were consented for the study, 69 were randomized to the control group, which received the usual management, and 73 were randomized to the study group, which received a cold compress to the abdomen before the procedure. In addition to data on the difference from pre- to postprocedure pain scales, we collected information regarding inserting provider type, gravidity/parity, body mass index, demographic information (age, race, insurance type, and level of education), history of IUD placement or cervical procedure, history of chronic pain, and the use of regular pain medications (defined as more than once per week). Statistical analysis was accomplished using t-test and chi square tests. Results: There was no difference in pre and postinsertional pain in those who received a cold compress versus the control during insertion of an IUD (3.4 vs. 3.5). The insertional pain was rated at 4.3 and 4.6 for patients who received the cold compress and the control group, respectively (p?=?0.805). Conclusion: Although a cold compress is a simple, inexpensive, and safe method of pain control, this study shows no reduction in insertional pain for IUD placement.
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spelling doaj.art-2487793590f04844b30fafc2e98254a82024-01-26T05:29:31ZengMary Ann LiebertWomen's Health Reports2688-48442020-08-011122723110.1089/WHR.2020.0056Cold Compress for Intrauterine Device Insertional Pain: A Randomized Control TrialJordan HyltonSarah MiltonAdam P. SimaNicole W. KarjaneBackground: Pain with intrauterine device (IUD) insertion is identified as a barrier to uptake of this highly effective long-acting reversible contraceptive. Several studies have assessed the efficacy of interventions to alleviate patient discomfort associated with IUD insertion, but no interventions have been clearly shown to improve procedural pain. The aim of this study was to determine whether use of a cold compress on the abdomen during IUD insertion reduces pain. Materials and Methods: This was a prospective randomized control trial of women presenting to Virginia Commonwealth University for insertion of IUD from September 2016 to October 2017. A power analysis determined that 69 subjects were needed in each arm to detect a 30% reduction in pain with a power of 80%, significance value of p?<?0.05. One hundred forty-two participants were consented for the study, 69 were randomized to the control group, which received the usual management, and 73 were randomized to the study group, which received a cold compress to the abdomen before the procedure. In addition to data on the difference from pre- to postprocedure pain scales, we collected information regarding inserting provider type, gravidity/parity, body mass index, demographic information (age, race, insurance type, and level of education), history of IUD placement or cervical procedure, history of chronic pain, and the use of regular pain medications (defined as more than once per week). Statistical analysis was accomplished using t-test and chi square tests. Results: There was no difference in pre and postinsertional pain in those who received a cold compress versus the control during insertion of an IUD (3.4 vs. 3.5). The insertional pain was rated at 4.3 and 4.6 for patients who received the cold compress and the control group, respectively (p?=?0.805). Conclusion: Although a cold compress is a simple, inexpensive, and safe method of pain control, this study shows no reduction in insertional pain for IUD placement.https://www.liebertpub.com/doi/full/10.1089/WHR.2020.0056contraceptioninsertional painintrauterine device
spellingShingle Jordan Hylton
Sarah Milton
Adam P. Sima
Nicole W. Karjane
Cold Compress for Intrauterine Device Insertional Pain: A Randomized Control Trial
Women's Health Reports
contraception
insertional pain
intrauterine device
title Cold Compress for Intrauterine Device Insertional Pain: A Randomized Control Trial
title_full Cold Compress for Intrauterine Device Insertional Pain: A Randomized Control Trial
title_fullStr Cold Compress for Intrauterine Device Insertional Pain: A Randomized Control Trial
title_full_unstemmed Cold Compress for Intrauterine Device Insertional Pain: A Randomized Control Trial
title_short Cold Compress for Intrauterine Device Insertional Pain: A Randomized Control Trial
title_sort cold compress for intrauterine device insertional pain a randomized control trial
topic contraception
insertional pain
intrauterine device
url https://www.liebertpub.com/doi/full/10.1089/WHR.2020.0056
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