Intrauterine Mepivacaine Instillation vs Placebo for Pain During IUD Placement: A Randomized Clinical Trial.

Intrauterine instillation of mepivacaine reduces pain during IUD placement by approximately 15 mm on a 100-mm scale in nulliparous individuals.

• Why it matters: Pain during IUD placement can deter women from choosing this contraceptive method, impacting reproductive autonomy and satisfaction. Addressing procedural discomfort is essential to improve patient experience and informed decision-making.
• What they did: A multicenter, double-blind, randomized trial involving 370 nulliparous women compared intrauterine mepivacaine to placebo saline, measuring pain scores during IUD insertion.
• The result: Mepivacaine significantly lowered pain scores and increased tolerability, with 98.3% reporting tolerable pain versus 91.4% in the placebo group, supporting its use to enhance patient comfort.