Evaluation of the effect of 10% lidocaine spray on reducing the pain of intrauterine device insertion: A randomised controlled trial

Background. The intrauterine device (IUD) is among the most efficient contraceptive methods. However, IUD insertion is accompanied by pain and discomfort.  Objectives. To evaluate the analgesic effects of 10% lidocaine spray in reducing pain during IUD insertion.  Method. In a randomised clinical trial, 80 volunteers attending two clinics for IUD insertion were selected for study, and randomly allocated to two groups. The intervention group received four puffs of 10% lidocaine spray on their cervix prior to IUD insertion. The routine procedure (without an analgesic) was followed in the control group. The intensity of perceived pain in both groups was measured using a visual analogue scale from 0 to 10.  Results. The two groups had significant differences in pain intensity at all stages of the procedure ( p <0.001). The most painful stage of the procedure was tenaculum placement (mean (standard deviation) pain intensity 2.2 (1.34) in the intervention group; 4.25 (1.92) in the control group).  Conclusion. Based on our findings, 10% lidocaine spray can be applied as a non-invasive, inexpensive, easy-to-use and accessible method to decrease IUD insertion pain.