Effect of oral ketoprofen on pain perception during copper IUD insertion among parous women: A randomized double-blind controlled trial

Abstract

Objective: The study aims to evaluate the analgesic effect of oral ketoprofen prior to copper intrauterine device (IUD) insertion on pain perception during the insertion procedure.Study design: A randomized double-blind controlled trial (Clinical Trials. Gov: NCT02905058).Setting: Assiut Women's Health Hospital, Assiut, Egypt. Materials and methods: The current study was conducted in the Family Planning Outpatient Clinic of a tertiary university hospital between October 2016 and February 2017. Parous women eligible for Copper IUD insertion were recruited and randomized in a 1:1 ratio to oral ketoprofen 150 mg or placebo tablets. The participants were asked to take 1 tablet of the study medications one hour before IUD insertion. The primary outcome was the difference in pain scores during the IUD insertion using a 10-cm Visual Analogue Scale (VAS). We considered a 1.5 cm difference in VAS scores between study groups as clinically significant. Results: One hundred forty women were enrolled (n = 70 in each group). ketoprofen significantly has lower mean pain score during all steps of IUD insertion with p < .001 except at tenaculum placement. Additionally, the duration of IUD insertion was significantly lower in the ketoprofen group (5.97 ± 1.78 vs. 7.20 ± 1.52 min, p = .023). The mean satisfaction scores were 7.04 ± 2.58 and 5.06 ± 2.01 in the ketoprofen and placebo groups respectively (p = .000). A lower ease of insertion score was observed among ketoprofen group (2.10 ± 1.59 vs. 3.70 ± 1.32, p = .016). No women reported adverse effects in both groups. Conclusion: This study depicts that the use of 150 mg oral ketoprofen prior to IUD insertion in parous women reduces the pain perception and increases the satisfaction of women with this highly effective long acting contraceptive method. Keywords: Intrauterine device, Family planning, Pain relief, Ketoprofen, NSAIDs, Contraception