Cold Compress for Pain Associated With Intrauterine Device Insertion: A Randomized Controlled Trial [5G

Abstract

INTRODUCTION: Pain with intrauterine device (IUD) insertion is identified as a barrier to compliance with 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 if use of a cold compress on the abdomen during intrauterine device insertion improves pain. METHODS: This study is a prospective, randomized controlled trial comparing cold compression to no intervention during IUD device insertion. Study participants were women who desired IUD placement at Virginia Commonwealth University OB/GYN clinics. Subjects were randomized to control (n=40) versus cold compress (n=47) and they completed a pre- and post-procedural visual acuity scale for pain. Additional data was collected regarding gravidity, parity, history of cervical procedures and socioeconomic status as well as history related to chronic pain. RESULTS: There was no difference in pre and post-insertional pain in those who received a cold compress versus the control during insertion of intrauterine device (3.6 versus 2.8, P=0.223). The insertional pain was rated at 4.5 and 4.7 for patients who received the cold compress and the control group, respectively (P=0.724). CONCLUSION: While a cold compress is a simple, inexpensive and safe method of pain control this study shows no improvement in insertional pain for intrauterine device placement.