Comparative efficacy of lidocaine-prilocaine cream and vaginal misoprostol in reducing pain during levonorgestrel intrauterine device insertion in women delivered only by cesarean delivery: A randomized controlled trial

Autor: Ahmed T. Hashem, Mostafa Mahmoud, Bassem Aly Islam, Mohamed Ibrahem Eid, Nancy Ahmed, Ahmed Mohamed Mamdouh, Rasha Elkomy, Amira Fouad Elgamel, A. A. Ali Hamada, Eman M. Khalil, Ahmed S. A. Ashour, Ahmed Said ali, Ayman Taher, Amr Hasan Hussein, Iman Elzahaby, Mohamed Hafez Mohamed Younes, Emad Salah, Eman M. Mojahed, Bassem Talaat, Mohamed ElHodiby, Nada Kamal Osman, Dalia Adel Nour, Yasser Khamis, Ayman Aly Hamed Elsallamy, Mahmoud Ahmed Gehad, Mohamed Mahmoud Mohamed Kotb, Sherine H. Gad Allah
Rok vydání: 2021
Předmět:
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and ObstetricsREFERENCES.
ISSN: 1879-3479
Popis: To compare efficacy of lidocaine-prilocaine (LP) cream versus misoprostol versus placebo before levonorgestrel-releasing intrauterine device (LNG-IUD) insertion.This randomized controlled trial (RCT) was conducted in a tertiary referral hospital from April 30, 2020 to March 1, 2021 on 210 parous women willing to receive LNG-IUD and delivered only by elective cesarean delivery (CD). Participants received 200 μg vaginal misoprostol or 5 ml of LP cream 5% or placebo 3 h before LNG-IUS insertion. Primary outcome was pain during LNG-IUD insertion, while secondary outcomes were pain 10 min post-procedure, ease of insertion, patient satisfaction, insertion time, and drug side effects.Pain during LNG-IUS insertion was reduced in LP group and misoprostol group compared to placebo group (2.1 ± 1.0 vs 3.7 ± 1.6; p 0.001) and (2.3 ± 1.3 vs 3.7 ± 1.6; p 0.001), respectively. Ease of procedure and patient satisfaction were significantly higher in LP and misoprostol groups than placebo (P 0.001). Need for additional analgesia was significantly higher in placebo group than in the other two groups (P = 0.009). Adverse events were not significantly different between the three groups except vomiting and abdominal cramps, which were higher with misoprostol.LP cream and 200 μg of vaginal misoprostol administration before LNG-IUD insertion in women delivered only by elective CD effectively reduced pain during insertion and 10 min post-procedure with easier insertions, high patient satisfaction, and tolerable side effects. Pain reduction with LP cream was clinically significant.
Databáze: OpenAIRE
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