title: Cervical lidocaine for IUD insertional pain: a randomized controlled trial.
abstract: OBJECTIVE
  Anticipated pain with intrauterine device (IUD) insertion may be a barrier to widespread use. Our objective was to evaluate the efficacy of intracervical 2% lidocaine gel for pain relief with IUD insertion.
  
  
  METHODS
  We performed a double-blind, randomized controlled trial of women undergoing IUD insertion. Participants were randomly assigned to 2% lidocaine or placebo gel. Study gel (3 mL) was placed 3 minutes prior to IUD insertion. Pain scores were measured at various time points using a 10-point visual analog scale.
  
  
  RESULTS
  Of the 200 participants randomized, 199 completed the study. Pain scores among lidocaine and placebo arms were similar at tenaculum placement (lidocaine and placebo: median, 4; range, 0-10; P = .15) and with insertion (lidocaine: median, 5; range, 1-10; placebo: median, 6; range, 0-10; P = .16). These results did not differ by parity.
  
  
  CONCLUSIONS
  Topical or intracervical 2% lidocaine gel prior to IUD insertion does not decrease pain scores.
authors.affiliation: Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA. mcnicholasc@wudosis.wustl.edu
authors.forename: Colleen P
authors.initials: CP
authors.lastname: McNicholas
authors.forename: Tessa
authors.initials: T
authors.lastname: Madden
authors.forename: Qiuhong
authors.initials: Q
authors.lastname: Zhao
authors.forename: Gina
authors.initials: G
authors.lastname: Secura
authors.forename: Jenifer E
authors.initials: JE
authors.lastname: Allsworth
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
mesh_terms: D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine