Practical advice for avoidance of pain associated with insertion of intrauterine contraceptives

被引:29
作者
Bahamondes, Luis [1 ]
Mansour, Diana [2 ]
Fiala, Christian [3 ,4 ]
Kaunitz, Andrew M. [5 ]
Gemzell-Danielsson, Kristina [4 ]
机构
[1] Univ Campinas UNICAMP, Dept Obstet & Gynaecol, Fac Med Sci, BR-13084971 Campinas, SP, Brazil
[2] Newcastle Hosp, New Croft Ctr, Newcastle Upon Tyne, Tyne & Wear, England
[3] Gynmed Clin, Vienna, Austria
[4] Karolinska Inst, Dept Womens & Childrens Hlth, Karolinska Univ Hosp, Stockholm, Sweden
[5] Univ Florida, Coll Med Jacksonville, Dept Obstet & Gynecol, Jacksonville, FL USA
关键词
RANDOMIZED CONTROLLED-TRIAL; NULLIPAROUS WOMEN; MISOPROSTOL PRIOR; DEVICE INSERTION; EXPERIENCE; SYSTEM; IUD;
D O I
10.1136/jfprhc-2013-100636
中图分类号
D669 [社会生活与社会问题]; C913 [社会生活与社会问题];
学科分类号
1204 ;
摘要
Few studies in the scientific literature provide clear direction on the prevention or management of pain associated with intrauterine contraceptive (IUC) placement. Those that have been published have studied small numbers of women and fail to provide definitive conclusions. There are also no guidelines available detailing recognised standard approaches to this problem. The consensus recommendations in this review focus primarily on non-pharmacological and often non-evidence-based interventions. This review includes general considerations, practical recommendations for both routine and more difficult cases and guidance on the optimal choice of instruments. General considerations, including pre-insertion counselling, the setting for the procedure, the confidence and technique of the provider and the interplay between the provider and assistant, can influence women's level of anxiety and, in turn, influence their perception of pain and their overall experience. Further studies are required to refine the optimal strategy for managing pain associated with IUC insertion.
引用
收藏
页码:54 / 60
页数:7
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