Evidence map›Paper›PMID 34715839›Full record

Trial reportBMC women's health2021

Use of naproxen versus intracervical block for pain control during the 52-mg levonorgestrel-releasing intrauterine system insertion in young women: a multivariate analysis of a randomized controlled trial.

Elaine Cristina Fontes de Oliveira, Thaís Baêta, Ana Paula Caldeira Brant, Agnaldo Silva-Filho, Ana Luiza Lunardi Rocha

2 registry-linked trialsOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC women's health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06853327 phase2enrolling by invitationnot on this mapstarted 2025, after this paper: background citation

Timing of Oral Ketorolac for Pain Reduction in IUD Insertion: A Double-Blind Randomized Controlled Trial

TypeinterventionalSponsorUniversity of North Carolina, Chapel HillRan2025 to 2026Enrolled108ConditionsIUD Insertion PainArmsKetorolac, Placebo
NCT07546370 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

The PLAN IUD Trial: The Effectiveness of Topical Prilocaine-Lidocaine Cream Plus Acetaminophen and Naproxen Compared to Lidocaine Injection Plus Acetaminophen and Naproxen to Manage Pain During IntraUterine Device Insertion: A Randomized Controlled Trial

TypeinterventionalSponsorMonakshi SawhneyRan2026 to 2027Enrolled66ConditionsPain During Intrauterine Device InsertionArmsPrilocaine, Lidocaine, Lidocaine HCl 1%
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Elaine Cristina Fontes de OliveiraDepartment of Obstetrics and Gynecology, Federal University of Minas Gerais, Avenida Professor Alfredo Balena 190, Santa Efigênia, Belo Horizonte, MG, 30130100, Brazil.
Thaís BaêtaDepartment of Obstetrics and Gynecology, Federal University of Minas Gerais, Avenida Professor Alfredo Balena 190, Santa Efigênia, Belo Horizonte, MG, 30130100, Brazil.
Ana Paula Caldeira BrantDepartment of Obstetrics and Gynecology, Federal University of Minas Gerais, Avenida Professor Alfredo Balena 190, Santa Efigênia, Belo Horizonte, MG, 30130100, Brazil.
Agnaldo Silva-FilhoDepartment of Obstetrics and Gynecology, Federal University of Minas Gerais, Avenida Professor Alfredo Balena 190, Santa Efigênia, Belo Horizonte, MG, 30130100, Brazil.
Ana Luiza Lunardi RochaDepartment of Obstetrics and Gynecology, Federal University of Minas Gerais, Avenida Professor Alfredo Balena 190, Santa Efigênia, Belo Horizonte, MG, 30130100, Brazil. ana_lunardi@yahoo.com.br.
Universidade Federal de Minas Gerais · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo compare the effectiveness of 550 mg naproxen sodium versus 6 mL 2%-lidocaine intracervical block in pain lowering at the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS) placement in young women.

methodsIn this randomized controlled trial, 100 women aged 15-24 years were block-randomized to receive either 6 mL 2%-lidocaine intracervical block 5 min before the LNG-IUS insertion or 550 mg naproxen 30 min before the procedure. Forty-nine women received 550 mg naproxen and 51 received intracervical block. The primary outcome was pain at LNG-IUS insertion. Secondary outcomes were ease of insertion, insertion failures, and correct IUS positioning. Neither participants nor doctors were blinded. Pain at insertion was assessed by using a Visual Analog Scale (VAS).

resultsWomen randomized to lidocaine intracervical block presented lower mean pain score at insertion, when compared to women who received naproxen (5.4 vs. 7.3, respectively; p < 0.001). Parous women had a 90.1% lower chance of experiencing severe pain (p = 0.004). There was a 49.8% reduction in the chance of severe pain for every 1-cm increase in the hysterometry (p = 0.002). The only complication observed during insertion was vasovagal-like reactions (7%). The insertion was performed without difficulty in 82% of the women. Participants in the intracervical block group presented higher proportion of malpositioned IUS on transvaginal ultrasound examination compared to women in naproxen group. Nevertheless, all the malpositioned IUS were inserted by resident physicians.

conclusionLidocaine intracervical block was found to be more effective than naproxen in reducing LNG-IUS insertion pain. TRIAL REGISTRATION NUMBER: RBR-68mmbp, Brazilian Registry of Clinical Trials, Retrospectively registered (August 4, 2020), URL of trial registry record: https://ensaiosclinicos.gov.br/rg/RBR-68mmbp/ .

Indexed as

Contraceptive Agents, FemaleIntrauterine Devices, MedicatedFemaleHumansLevonorgestrelMultivariate AnalysisNaproxenPainContraceptive Agents, FemaleLevonorgestrelNaproxenAdolescentIntrauterine contraceptionIntrauterine deviceIUD insertion painNulliparousPain relief

Identifiers

PMID34715839
PMCPMC8556879
OpenAlexW3161633579

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.