Tegan A Hunter1, Sarita Sonalkar2, Courtney A Schreiber2, Lisa K Perriera3, Mary D Sammel4, Aletha Y Akers5. 1. University of Miami Miller School of Medicine, Miami, Florida. Electronic address: thunter@med.miami.edu. 2. Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. 3. Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania. 4. Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania. 5. Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Abstract
STUDY OBJECTIVE: To identify predictors of anticipated pain with intrauterine device (IUD) insertion in adolescents and young women. DESIGN: We performed linear regression to identify demographic, sexual/gynecologic history, and mood covariates associated with anticipated pain using a visual analogue scale pain score collected as part of a single-blind randomized trial of women who received a 13.5-mg levonorgestrel IUD. SETTING:Three academic family planning clinics in Philadelphia Pennsylvania. PARTICIPANTS: Ninety-three adolescents and young adult women aged 14-22 years. INTERVENTION: Participants received either a 1% lidocaine or sham paracervical block. MAIN OUTCOME MEASURES: Anticipated pain measured using a visual analogue scale before and perceived pain at 6 time points during the IUD insertion procedure. RESULTS:Black or African American participants had a median anticipated pain score of 68 (interquartile range [IQR], 52-83), White participants had a median anticipated pain of 51 (IQR, 35-68), whereas participants of other races had a median anticipated pain score of 64 (IQR, 36-73); P = .012. In multivariate analysis, race was the only covariate that significantly predicted anticipated pain at IUD insertion. Women with anticipated pain scores above the median had significantly higher perceived pain during all timepoints of the IUD insertion procedure. CONCLUSION: Increased anticipated pain is associated with increased perceived pain with IUD insertion. Black adolescent women experience greater anticipated pain with IUD insertion. This population might benefit from counseling and clinical measures to reduce this barrier to IUD use.
RCT Entities:
STUDY OBJECTIVE: To identify predictors of anticipated pain with intrauterine device (IUD) insertion in adolescents and young women. DESIGN: We performed linear regression to identify demographic, sexual/gynecologic history, and mood covariates associated with anticipated pain using a visual analogue scale pain score collected as part of a single-blind randomized trial of women who received a 13.5-mg levonorgestrel IUD. SETTING: Three academic family planning clinics in Philadelphia Pennsylvania. PARTICIPANTS: Ninety-three adolescents and young adult women aged 14-22 years. INTERVENTION: Participants received either a 1% lidocaine or sham paracervical block. MAIN OUTCOME MEASURES: Anticipated pain measured using a visual analogue scale before and perceived pain at 6 time points during the IUD insertion procedure. RESULTS: Black or African American participants had a median anticipated pain score of 68 (interquartile range [IQR], 52-83), White participants had a median anticipated pain of 51 (IQR, 35-68), whereas participants of other races had a median anticipated pain score of 64 (IQR, 36-73); P = .012. In multivariate analysis, race was the only covariate that significantly predicted anticipated pain at IUD insertion. Women with anticipated pain scores above the median had significantly higher perceived pain during all timepoints of the IUD insertion procedure. CONCLUSION: Increased anticipated pain is associated with increased perceived pain with IUD insertion. Black adolescent women experience greater anticipated pain with IUD insertion. This population might benefit from counseling and clinical measures to reduce this barrier to IUD use.
Authors: Aletha Y Akers; Caren Steinway; Sarita Sonalkar; Lisa K Perriera; Courtney Schreiber; Jennifer Harding; J Felipe Garcia-Espana Journal: Obstet Gynecol Date: 2017-10 Impact factor: 7.661
Authors: Peter H Pan; Ashley M Tonidandel; Carol A Aschenbrenner; Timothy T Houle; Lynne C Harris; James C Eisenach Journal: Anesthesiology Date: 2013-05 Impact factor: 8.986
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